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This appeal concerns a 17 year-old girl who is severely disabled, and her caregivers have requested that she undergo a sterilization operation. She shows no signs of ever being able to give informed consent, and can only communicate at a two year-old level. She is epileptic, and known to have violent outbursts. She also does not like children, and was known to act like a "wild animal". She will never be able to totally care for herself. She cannot understand the link between intercourse and childbirth. She cannot understand sexual education, but has recently shown signs of sexual arousal. The hospital trust is applying to have a tubal ligation. B. has been in institutional care since age 4.


  1. Can non-therapeutic sterilizations never be allowed for patients incapable of giving informed consent?
  2. Is this in the best interests of the individual?


Appeal dismissed.


The Lords unanimously find that pregnancy would result in harm to the concerned woman. Further, options of non-invasive birth control are not realistic because their chance of success is unknown, and there might be harsh side effects with her current epilepsy medication. Further, she is so obese that a pregnancy might not be discovered until too late into her term for an abortion to be performed. The delivery process would also be likely to cause her to panic. It seems that a tubal ligation, a minor surgery, is the best option, but B. will never be able to give informed consent for the procedure.

Lord Oliver says that the distinction of "therapeutic" surgery is of no use in this case as all that is concerned is whether or not the surgery is in the best interest of the individual. He mentions La Forest's decision in E. (Mrs.) v Eve and says that if the barring of "non-therapeutic" surgeries meant a barring of surgeries intended to prevent future harm, then he disagrees. This case is not about sterilization for social purposes or anything else except for the best interests of the individual.

Lord Hailsham further criticizes La Forest's judgment, and says that the distinction between therapeutic and non-therapeutic operations is meaningless in this case.


"Non-therapeutic" surgeries on disabled patients will be allowed to proceed in cases where the procedure is in the best interests of the individual concerned.