Surgeons can perform a hysterectomy on a paranoid schizophrenic who has been diagnosed with ovarian cancer and lacks the mental capacity to make decisions about treatment, a judge has ruled after a hearing in a specialist court.
Mr Justice MacDonald has concluded that surgery would be in the woman's best interests after bosses at an NHS hospitals trust with responsibility for any cancer treatment asked him for rulings.
The judge said he would outline the reasoning behind his decision in a written judgment which would be published soon.
He had analysed the case at a public hearing in the Court of Protection - where judges consider issues relating to sick and vulnerable people who might not be mentally capable of making decisions - in London.
The woman's interests had been represented by staff from the office of the Official Solicitor - who help vulnerable people embroiled in litigation.
Lawyers representing the NHS trust said the woman, who is in her 30s, had "expressed a wish" to have a child.
But they said doctors thought that she would die before the year ended if she did not have surgery.
A barrister instructed by the Official Solicitor had supported the trust's application and said evidence relating to the diagnosis seemed "overwhelming".
Mr Justice MacDonald ruled that the woman could not be identified.
The judge said the trust which asked for rulings was based in the east of England.
But he ruled that the trust could not be named until the woman had undergone surgery, left hospital and returned to a specialist mental health unit.
He said he wanted to ensure that there was no possibility of the woman being recognised.
Barrister Vikram Sachdeva QC, who represented the hospitals trust, said the woman had been diagnosed with ovarian cancer earlier this year.
He said she had "expressed a wish to have a child" and he described the case as tragic.
"She was admitted to hospital ... for surgery but declined it, which has necessitated this application to the court," he told Mr Justice MacDonald.
"Without surgical treatment her life expectancy - assuming the diagnosis of ovarian cancer is correct, the probability is at least 80% - is approximately six months.
"If she has surgery she has the chance of a cure, and likely survival of at least three to five years."
Barrister Conrad Hallin, who represented the woman's interests and had been instructed by the Official Solicitor, supported the trust's application and said "in terms of the diagnosis the evidence seems overwhelming".
Mr Justice MacDonald said he was satisfied that the woman lacked the mental capacity to make decisions.