Legal Case Summary
Re F (Mental Patient Sterilisation) [1990] 2 AC 1
Whether medical practitioners are able to sterilise a mentally handicapped woman who is unable to consent on the basis that doing so is in her best interest.
Facts
The subject of the judgment was a thirty-six year-old mentally handicapped woman who lived voluntarily in a mental hospital and had the mental age of a small child. The woman had developed a sexual relationship with a male patient. The woman’s doctors were of the view that the woman would not cope with pregnancy and childbirth and because no other method of contraception was desirable and because it would not be in the woman’s best interests for the staff to prevent her activity, it was considered in the patient’s best interest to be sterilised. The patient’s mother sought a declaration from the court that such steps would not be unlawful for lack of consent. A declaration was given at first instance and upheld by the Court of Appeal.
Issues
The House of Lords was asked to consider whether (1) this was an issue that the court should be involved in (2) what the jurisdiction of the court was in these circumstances and (3) what procedure should be followed.
Decision / Outcome
It was held (1) that although the under the common law a doctor was able to operate on a patient who was unable to consent when it was in the patient’s best interest and therefore the consent of the court was not strictly necessary, given the particular nature of sterilisation, the court should be consulted in these circumstances. (2) The court’s jurisdiction, under the current law, was founded in a declaration under the Rules of the Supreme Court (Revision) (SI 1965/1776), ord 16, as requested by the mother. (3) The declaration procedure was the correct one, although amendments should be made to RSC Ord 80, to allow this to apply to circumstances such as these.
Updated 20 March 2026
This case summary accurately describes the decision in Re F (Mental Patient: Sterilisation) [1990] 2 AC 1 and the legal principles established by the House of Lords at that time. However, readers should be aware that the legal framework governing treatment of incapacitated adults in England and Wales has been substantially superseded by statute.
The Mental Capacity Act 2005 now provides the primary legislative framework for decisions made on behalf of adults who lack capacity, replacing much of the common law developed in cases such as Re F. The Act codifies the best interests principle, introduces a formal decision-making framework, and establishes the Court of Protection with a specific statutory jurisdiction over welfare and medical treatment decisions. Section 5 of the Act provides statutory authority for acts done in connection with the care or treatment of a person lacking capacity, provided the person carrying out the act reasonably believes the person lacks capacity and that the act is in their best interests.
Under the current position, sterilisation of a person lacking capacity remains a matter requiring court authorisation, but this is now sought through the Court of Protection under the Mental Capacity Act 2005 rather than by way of declaration under the Rules of the Supreme Court. The procedural references in the article to RSC Ord 16 and Ord 80 are therefore no longer the operative procedure. Court of Protection Practice Direction 9E identifies serious medical treatment cases — including non-therapeutic sterilisation — which must be brought before the court.
The article is a useful summary of an important and still-cited case, but it should be read alongside the Mental Capacity Act 2005 framework, which governs this area of law today.
