LONDON -- A 16-year-old girl lost her case before England's Court of Appeal yesterday. The decision may have saved her life.
But it also seemed to diminish what one legal source described as "the principle in our statutes that 16- or 17-year-olds should have the absolute right to consent to, or refuse, medical treatment."
J, as she is called to protect her privacy, doesn't want to eat anymore. She was appealing a ruling that gave her local council, a political subdivision, the authority to treat her against her will for anorexia.
Anorexia is a psychological disorder that often afflicts teen-aged girls; they develop an obsession with weight loss and an aversion to food.
The council has J in its care because she is an orphan, a child whose life has seen a succession of tragedies. Her mother died of cancer, her father from a brain tumor. Two years ago her grandfather, of whom she was very fond, died.
It was at that point that J began to lose weight.
The decision by the justices -- Lords Donaldson, Balcombe and Nolan -- seemed to curb at least to some degree the rights accorded children after the age of 16 under the Family Law Reform Act of 1969.
Allan Levy, the girl's lawyer, argued that the law gave her the right to the same autonomy enjoyed by people over 18 to refuse treatment.
J, he argued, has a "conclusive right" in the matter of her own treatment. But the court said they were "qualified rights."
Dr. Graham Burt of the Medical Defense Union appeared to agree with Mr. Levy. The union is a doctors organization that provides legal and ethical advice to physicians facing difficult moral choices in the treatment of patients. Though not strictly an insurance company, the union also provides coverage for malpractice.
"We always advise doctors to take account of their patients' wishes [when it comes to refusing treatment], and if the patient is competent then the doctor must abide by those wishes, even if he thinks the patient is wrong," said Dr. Burt.
"This child [J] is over 16," he said, "One would think the doctor must take her opinion into account."
Whether the Appeal Court justices were ruling against the Family Law Reform Act is unclear. But it was clear that the girl has deterioratedto a condition in which her judgment is affected.
The lawyer for the local council that has J in its care said her last meal, a bowl of cornflakes, was nine days ago. She is said to stand 5 feet 7 inches tall and to weigh only about 77 pounds.
In ruling against the teen-ager who doesn't want to eat, Justice Donaldson said, "There are occasions when public interest has to override personal interest."
But he did not explain how the public interest would be affected by the case.