Roger Pearson reports on the case of a woman challenging the rights of doctors to treat those detained under the Mental Health Act

The Court of Appeal has paved the way for a major test case on the right of doctors to carry out treatment on patients detained under the Mental Health Act and on the right of local authorities to detain people under the Act for questionable reasons.

The case centres on a caesarean section carried out on 29-year-old Miss S, while she was detained under the Act. The woman, who has an aversion to medical procedures, was detained on the basis that the appearance of mental disorder was sufficient for detention.

Consent was sought from Mrs Justice Hogg in the Family Division of the High Court for doctors at St George's Hospital, Tooting, to carry out a caesarean. The judge gave her consent after being told Miss S had developed potentially life-threatening pre-eclampsia and that doctors feared for her health and her baby. A girl was later delivered by caesarean.

Miss S is challenging the procedure under which the health authority sought and obtained leave to carry out the operation against her wishes.

She is seeking judicial review of moves by London Borough of Merton social worker, Louize Collins, who made the original application for her to be detained under the Act, and of the actions of the NHS trusts responsible for the Springfield Hospital, where she was initially detained, and St George's.

She argues that she was not given a chance to be represented at the hearing at which consent was obtained for the caesarean. She claims hospital managers failed to keep her informed and Mrs Justice Hogg was misled. She will argue that the judge was told she had been in labour for 24 hours and could die at any minute. She says she had never been in labour.

Miss S wants clarification of criteria necessitating detention.