Dame Elizabeth Butler-Sloss, president of the high court's family division, is the first woman to reach such exalted heights in the judiciary. In 1988, amid the Cleveland child abuse scandal that propelled her into the limelight, she became the first female judge in the court of appeal.
Yet her CV, before she went to the high court in 1979 at the age of 46, looked thin. She is one of only a handful of senior judges not to have gone to university, and was promoted to the high court bench from what was seen as the dead-end job of divorce registrar.
Now 68, a mother of three and a grandmother, she comes from a prominent legal family. Her father, Sir Cecil Havers, was the high court judge who sentenced to death Ruth Ellis, the last woman to be executed in Britain. Her brother, Michael Havers, was attorney general and briefly lord chancellor in Margaret Thatcher's government (in her youth she herself stood unsuccessfully as a Tory candidate in an unwinnable south London constituency). Her nephew Philip Havers QC, brother of the actor Nigel, appeared before her to argue Ms B's case. Her husband, Joseph Butler-Sloss, was a high court judge in Kenya before he retired.
Dame Elizabeth drew plaudits for her chairmanship of the Cleveland inquiry, which slammed doctors and social workers for riding roughshod over parents' and children's rights, and laid down a blueprint for the handling of suspected child abuse cases.
Lawyers praise her for her empathy, and for her ability to get to the nub of a case. In Ms B's case, she felt for the doctors who were asked, as they saw it, to kill a patient they knew and liked, as well as for the woman treated against her will. But she immediately isolated the one real issue in the case: was Ms B competent to take decisions for herself? Everything else, including the doctors' wishes, was irrelevant.
She has been down this path before, in 1998, when she stepped in after a string of cases in which judges with a less firm grasp of medical law had allowed doctors to force pregnant women to undergo caesarean sections against their will. The practice was stopped after Dame Elizabeth confirmed in an appeal that a mentally competent woman could not be forced to undergo an operation even if her refusal meant certain death for her or her child.
She has upheld the right of a 15-year-old girl to have an abortion against her parents' wishes, and the right of parents not to have their small son undergo medical treatment against their wishes.
She used the Human Rights Act, with its guarantee for the right to life, to grant an unprecedented lifetime injunction protecting the new identities of Robert Thompson and Jon Venables, the killers of two-year-old James Bulger.
Unafraid of expressing controversial views, she suggested at a press conference to mark her appointment as president in 1999 that gay couples could successfully bring up children. "We should not - and do not - close our minds to suitable families who are clearly not within the old-fashioned approach," she said.
