Monday 26 September 2016

Profoundly disabled girl (10) need not receive emergency life-saving treatment - High Court rules

Tim Healy

Published 10/07/2015 | 02:30

The child was admitted to hospital at four months of age with serious brain damage and has been in State care almost since then
The child was admitted to hospital at four months of age with serious brain damage and has been in State care almost since then

An acutely ill, profoundly disabled 10-year-old girl who is in State care need not receive emergency life-saving intervention if her doctors do not believe it in her interests, the High Court has ruled.

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She will receive all palliative care but should she require cardiac resuscitation, surgery, artificial ventilation, or general anaesthesia, doctors have been given permission to follow their clinical judgment not to provide such aggressive treatment.

Her doctor wants her to be able to return to residential care, which has been her home for most of her life, where she can live out her last days in comfort and peace.

Read more: Low-key ruling puts sharp focus on sensitive end-of-life care debate

The court heard the child, who is acutely ill after developing pneumonia, was admitted to hospital at four months of age with serious brain damage and has been in State care almost since then.

She is profoundly intellectually disabled and unable to communicate verbally, although she smiles when happy and cries when unhappy. She cannot be fed orally.

She is wheelchair bound, suffers severe spastic quadriplegia, epilepsy, scoliosis, a heart condition and suffers recurrent life-threatening infections.

She'd been happy in residential care, had attended a special school and enjoyed music. Last year, she made her First Communion and went on holiday.

Her mother supported the doctors but said she should not be "pumped full of morphine unnecessarily".

Ms Justice Iseult O'Malley said the hospital had sought the order on the basis that it is highly unlikely the girl will recover from her present condition. Even if she does, she will have an extremely poor quality of life and will inevitably face another life-threatening event in the near future.

The judge said she was obliged to act in the child's best interests. This includes taking account of her current illness, the length and quality of life and the suffering inherent in the current course of treatment or in any possible future aggressive treatment, the judge said.

Views

She was also taking into account the views of doctors and the child's parents.

It was not for the judge to impose her views as to whether potential quality of life would be tolerable, she said, but to ask what would the child do if she were in a position to make a sound judgment.

There is a strong presumption in favour of life-saving treatment and the courts will never authorise positive steps to accelerate death or terminate life. However, in exceptional circumstances, authorisation may be given that steps not be taken to prolong life.

The judge accepted the doctors' view that further aggressive treatment was not in the girl's best interests. It might, for some relatively brief period, prolong life but the likelihood is that it would be futile and come at the cost of inflicting further suffering.

Irish Independent

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