A 22-YEAR-old woman suffering from anorexia and refusing nutritional feeds in hospital is to be fed through a tube by the order of a court.
High Court president, Mr Justice Nicholas Kearns, said it was a life or death situation and he was making an order to feed the young woman immediately, as her medical carers deem appropriate.
The judge said everybody was trying to do their best for the unfortunate woman whom the court heard will die if she does not get the treatment required.
The HSE made an application to the court to have her fed by tube. The application was was supported by her parents.
None of the parties or the hospital can be identified by order of the court.
A consultant doctor, in an affidavit to the court, said the woman urgently requires medical intervention to safeguard her life. The prognosis is so grave that she will simply not survive for much longer if her body does not get the nutrients it requires.
The court heard the woman had refused four out of seven oral nutritional supplements in the last 24 hours and due to her low body weight- which currently at 32.8kg with a BMI of 12.2.- she runs the risk of collapse.
Her medical team believe she needs to restore her weight by seven kg to allow her to be sufficiently stable to function outside of the hospital.
She does not accept she will die if she refuses further nutrition.
Making the application,Peter Finlay SC for the HSE, said the woman had anorexia nervosa for ten years and has been admitted to hospital three times.
In an affidavit, a consultant physician in gastroenterology said the woman had been admitted to hospital in late 2012 as a result of starvation due to anorexia.
Her body weight was 26 kg and she had a body mass index (BMI) of 9.8.
She had to be artificially ventilated and a gastronomy tube was inserted in order to feed her safely.
When she regained consciousness she was insistent she could maintain her weight and was eventually discharged.
The consultant said unfortunately there have been two re-admissions since then which have lasted for several months.
She has remained in hospital continuously since the middle of last year.
The consultant said her current situation is extremely grave and her weight had dropped to 21 kg with a BMI of 8 prior to the latest re-feeding, which she has now refused.
Despite her actions to the contrary, she has stated she does not wish to die and has consented to all other medical treatment.
A psychiatrist, in an affidavit, said the woman had agreed to oral supplements but when she restored some weight she could no long agree to a continuous plan of re-feeding and began to refuse feeds.
A multi-disciplinary team who are looking after her believes she does want treatment but is unable to accept it due to the severity of her anorexia.
Her counsel, Michael Ramsey, asked the court for a short adjournment to allow an independent psychiatric report to be carried out.
Mr Justice Kearns said that application can be made when the case come backs before him next Tuesday. In the meantime, he said she could be fed as her medical team deemed appropriate.