Blogs

Mentally Ill Prisoner Denied Termination

05 Sep 2017

Karen Stephens 110x137

by Ms Karen Stephens

Doctor speaks to distressed female patient

A mentally ill prisoner had an application to terminate her high-risk twin pregnancy at 20 weeks rejected because she did not have the capacity to make decisions about her health.

The Queensland Civil and Administrative Tribunal (QCAT) decision involves “QDB”, a 33 year old classified patient under the Mental Health Act. QDB has a history of mental illness (schizophrenia and delusional disorder), drug use and hepatitis C. She had been incarcerated for breach of bail conditions involving drug use, and was transferred to hospital due to relapse of her schizophrenia. QDB requested the termination of her pregnancy. 

QCAT considered:

Whether QDB had capacity to make a decision about the termination

QCAT accepted the evidence of Dr MA, QDB’s treating psychiatrist, that QDB lacked the capacity to make decisions. Dr MA said that QDB gave no reasons why she wanted the termination and did not understand the nature and effect of the decision. 

Doctors must assess patients’ decision-making capacity in a variety of situations and it can be challenging. To demonstrate decision-making capacity, a person will be able to:

  • understand the facts of the situation
  • understand the main choices available
  • weigh up those choices, including benefits and risks
  • make and communicate the decision
  • understand the ramifications of the decision.

Whether termination of pregnancy was necessary to preserve QDB from serious danger to her life or physical or mental health

Based on the evidence of two doctors with obstetric expertise, QCAT concluded that although QDB’s pregnancy was higher risk than a normal pregnancy, there was no evidence of serious danger to QDB’s life or physical or mental health if the pregnancy continued. Therefore consent to termination of pregnancy could not be given.

A recent case before the NSW Civil and Administrative Tribunal allowed a pregnancy termination because of proven danger to the 19 year old mother’s health.

This blog contains general information only. We recommend you contact your medical defence organisation or insurer when you require specific advice in relation to medico-legal matters.

 

 

Library

My Career Journey with Dr Nick Coatsworth

Dr Nick Coatsworth is an expert in health policy, public administration and a practising infectious diseases physician. He held a national role in the Australian response to COVID-19 as Deputy Chief Medical Officer of Australia, becoming one of the most recognised medical spokespeople during the pandemic. Nick engaged the Australian community through a variety of media platforms most notably as the spearhead of the national COVID-19 vaccination campaign. Dr Micheal Gannon, Obstetrician & Gynaecologist, sits down with Dr Nick Coatsworth to discuss Nick's medical career journey, and what insights and advice he has for junior doctors. MDA National would like to acknowledge the contributions of MDA National staff, Members, friends and colleagues in the production of the podcast and note that this work is copyright. Apart from any use permitted under applicable copyright law, you may not reproduce the content of this podcast without the permission of MDA National. This podcast contains generic information only, is intended to stimulate thought and discussion, and doesn’t account for requirements of any particular individual. The content may contain opinions which are not necessarily those of MDA National. We recommend that you always contact your indemnity provider when you require specific advice in relation to your insurance policy or medico-legal matters. MDA National Members need to contact us for specific medico-legal advice on freecall 1800 011 255 or email advice@mdanational.com.au. We may also refer you to other professional services.

Podcasts

09 Jun 2022

Career complications and contending with uncertainty

Among the many challenges of the COVID-19 pandemic for junior doctors is how to respond to medical training impacts and career uncertainty. In this podcast, Dr Caroline Elton (a psychologist who specialises in helping doctors)and Dr Benjamin Veness (a Psychiatry registrar) share advice for coping with medical training and career delays, disruptions and unknowns.

Podcasts

10 Aug 2020