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Observations Ethics Man

The judge as medical ethicist

BMJ 2013; 347 doi: (Published 29 August 2013) Cite this as: BMJ 2013;347:f5299
  1. Daniel K Sokol, honorary senior lecturer in medical ethics and law at King’s College London and a barrister
  1. daniel.sokol{at}

Doctors and ethicists can learn much about practical decision making from High Court judgments

D is 36 years old. He has a mental age of between 6 and 9 years and an IQ of 40. For the past 10 years he has enjoyed a loving relationship with a woman, P, who also has a learning disability.

Three years ago P became pregnant. The resulting child had such a disruptive effect on D and P that their relationship nearly fell apart. Neither parent was able to care for the child, and the council started care proceedings. So upset was D by the experience that he did not want any more children. Last year a court declared that D did not have the capacity to consent to sexual relations, and so D and P could meet only under supervision. This restriction led to a significant loss of independence for D.

To resolve the problem D’s parents considered the possibility of a vasectomy for D. The risk of chronic or severe scrotal pain from the vasectomy was 0.5%.

At the trial in July 2013 Mrs Justice Eleanor King, in the Court of Protection, was faced with this question: was it in …

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