Applications for consent to special medical treatment

NXM [2014] NSWCATGD 52  saw an application in early 2014 for consent to special medical treatment, being an hysterectomy with ovarian conservation for an 18-year-old woman. The tribunal was required to consider whether the treatment was necessary to save the patient’s life or prevent serious damage to the patient’s health.

Miss NXM has a severe intellectual disability and Chromosome 17 Duplication. The proposed surgery was for the purpose of the permanent elimination of menstruation which in the case of Miss NXM is “heavy and troublesome menstruation”. Medical evidence suggested that the patient had an inability to look after her own hygiene.

The Tribunal was satisfied that the evidence provided by Dr KGF and Dr DVB establishes that hormonal treatments for stopping Miss NXM’s menstruation carry significant risk for Miss NXM.

At [68] – [69] the Tribunal concluded that in the absence of further evidence in the form of assessments and opinions from mental health professionals, the Tribunal could not be satisfied that these matters are such that they need to be addressed to prevent “serious harm” to Miss NXM’s mental health. The test set out in the Act is not a “best interest” test, but the more stringent test as mentioned above.

NXM (No 2) [2014] NSWCATGD 53 saw a subsequent application, with more detailed evidence provided. On that occasion the Tribunal consented to the hysterectomy with preservation of ovaries under general anaesthetic on the basis that the proposed special treatment was necessary to prevent serious damage to Miss NXM’s health.

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