Lisa Hallgarten asserts that there is no suggestion that a caesarean carried out on an Italian woman "without her … consent … was necessary to protect her health or life, only that it was requested by social services to remove the baby for child protection purposes" (A shift from principle, 3 December). This is a misunderstanding of what both ethical medical practice and the law requires, and could never have been an accurate account of what occurred in this case.
She proclaims that "Pregnant women in Britain maintain the right to bodily autonomy and consent over medical treatment, even when carrying a baby to full term might jeopardise either their foetus's health or their own." But this obviously does not apply when the patient lacks capacity to consent, which is why hospitals do not abandon the treatment of patients with dementia or severe learning disability or those who are comatose or psychotic.
While Ms Hallgarten worries that whether capacity can ever be determined "is an open question", it is a matter of daily professional practice for thousands of clinicians up and down the country, as is their concern for the effect of their treatment on the patient, including this one.
In contrast to Ms Hallgarten's fears, a pregnant woman living in the UK can indeed "still expect a request for help, or an admission of a health problem, to be met with support – not prosecution, forced medical intervention or automatic loss of child custody". It is as dangerous to stigmatise the mental health and social services as uncaring, cruel child snatchers as it is to demonise the mentally ill as dangerous psychopaths.
Evan Harris
London
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