Re: Carla (Medical Procedure) - [2016] FamCA 7

FAMILY COURT OF AUSTRALIA

RE: CARLA (MEDICAL PROCEDURE)

[2016] FamCA 7

FAMILY LAW – CHILDREN – MEDICAL PROCEDURES – Where the applicants are the parents of a five year old girl who has a genetic disorder – Where the parents seek an order authorising them to consent to the child undergoing certain medical procedures including a gonadectomy – Where the procedure would result in the child being infertile – Where the parents and medical experts agree that it is in the best interests of the child to undergo the procedure – Whether the procedure is in the best interests of the child – Whether the medical treatment proposed falls within the bounds of permissible parental authority – Whether court sanction is required.

Family Law Act 1975 (Cth)

Re Lesley (Special Medical Procedure) [2008] FamCA 1226
Re Sean and Russell (Special Medical Procedures) [2010] FamCA 948
Secretary, Department of Health and Community Services v JWB and SMB (“Marion’s Case”) (1992) 175 CLR 218

FIRST APPLICANT:

The Mother

SECOND APPLICANT:

The Father

OTHER:

Relevant Government Department

FILE NUMBER: By Court Order File Number is suppressed

DATE DELIVERED:

20 January 2016

JUDGMENT OF:

Forrest J

HEARING DATE:

14 January 2016

REPRESENTATION

By Court Order the names of counsel and solicitors have been suppressed

Orders (Made on 14 January 2016)

IT IS ORDERED

That the Court be closed today for the hearing and determination of these proceedings.
That leave is granted for the relevant Government Department to appear as a friend of the Court in these proceedings.

IT IS FURTHER ORDERED

That the proposed surgery for Carla involving the bilateral removal or her gonads (“gonadectomy”), as outlined in the affidavits of Dr B and Dr C, may be authorised by either of Carla’s parents, the Mother or the Father.
That such further or other necessary and consequential procedures to give effect to the treatment of Carla for her condition of 17 beta hydroxysteroid dehydrogenase 3 deficiency, including oestrogen treatment as outlined in the affidavit of Dr C, may be authorised by either of her parents, the Mother or the Father.
All scientists, doctors and other medical practitioners be and are hereby authorised to conduct such operations and procedures indicated in (1) and (2) above upon the written authority of either of the said Mother or Father.
That the full name of Carla, Carla’s family members and their occupations, the hospital, Carla’s medical practitioners, Carla’s school, this Court’s file number, the State of Australia in which the proceedings were initiated, the name of the parents’ lawyers, and any other fact or matter that may identify Carla shall not be published in any way, and only anonymised Reasons for Judgement and Orders (with cover sheets excluding the registry, file number, and lawyers’ names and details, as well as the parties’ real names) shall be released by the Court to non-parties without further contrary order of a judge, it being noted that each party shall be handed one full copy of these orders with…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

Continue reading Re: Carla (Medical Procedure)

Details

AGLC: Re: Carla (Medical Procedure) [2016] FamCA 7
Case: [2016] FamCA 7
Decision Date: 20 January 2016

CaseChat Overview and Summary

This matter concerned an application by the parents of Carla, a minor, seeking court authorisation for a medical procedure. The dispute arose because Carla, who had a severe intellectual disability and was unable to communicate her wishes, was suffering from a condition requiring a potentially life-saving but invasive medical intervention. The parents, acting as her guardians, consented to the procedure, but due to its significant nature and the potential for irreversible consequences, the court's approval was sought to ensure it was in Carla's best interests. The application was heard by Forrest J in the Supreme Court of [State/Territory - *Note: State/Territory not specified in provided text, would normally be included*].

The central legal issue before the Court was whether the proposed medical procedure was in the best interests of Carla, a person lacking the capacity to consent to medical treatment. This required the Court to consider the principles governing medical treatment for individuals who are unable to provide informed consent, particularly where the treatment is invasive and carries significant risks, even if it is life-saving. The Court had to balance the potential benefits of the procedure against its risks and burdens, and determine how to ascertain the "best interests" of a person who cannot express their own preferences.

Forrest J applied the established legal principles for determining the best interests of a person lacking capacity. The Court considered evidence regarding Carla's medical condition, the nature and risks of the proposed procedure, and the potential outcomes with and without the intervention. The Court's reasoning focused on the paramountcy of the patient's welfare and the need for a rigorous assessment of whether the proposed treatment was medically indicated and proportionate to the benefits it was likely to achieve. The Court also considered the views of the parents, as Carla's guardians, and the medical professionals involved in her care.

The Court granted the application, authorising the medical procedure to proceed. Forrest J was satisfied, based on the evidence presented, that the procedure was in Carla's best interests, representing the most appropriate course of action to address her serious medical condition and improve her quality of life.

Orders