A new head has been appointed for the High Court's family division, which deals with the most sensitive issues of medical treatment - those involving patients who may lack the capacity to take their own decisions.

Dame Elizabeth Butler-Sloss took over on 1 October as president of the division - the judge who personally hears the most difficult and highly charged cases, such as right-to-die applications for patients in a persistent vegetative state.

Her predecessor, Sir Stephen Brown, gave the original go ahead for doctors to withdraw artificial feeding from Tony Bland, the severely brain-damaged survivor of the Hillsborough football ground disaster, and also, controversially, sanctioned the first forced Caesarean.

His Caesarean ruling was strongly criticised by legal commentators, who pointed out that the law gives an adult who is competent to take such decisions an absolute right to refuse treatment even if the price is death for her or her unborn child.

But other family division judges followed his lead in a string of cases. It was left to three Appeal Court judges, headed by Dame Elizabeth, to stem the tide on the first appeal by a woman who had been operated on against her will.

Sir Stephen was an old-school family division judge. But Dame Elizabeth is expected to bring a new rigour to the job.

She is the first woman to reach such heights in the judiciary, and was previously the first of her sex to get to the Court of Appeal. Apart from her knowledge of medical law, by no means a universal attribute among family judges, she is known for her common sense and humanity.

Last month she gave the lead judgement when the Appeal Court refused permission for the parents of a baby, whose HIV-positive mother is breastfeeding her, to appeal against a High Court ruling that the baby should be blood-tested.