Thursday 22 August 2019

Anorexia specialist concerned at feeding order cases

Mr Justice Peter Kelly. Picture: Frank McGrath
Mr Justice Peter Kelly. Picture: Frank McGrath

Tim Healy

An eating disorders specialist has expressed serious concern to the president of the High Court that doctors have to go to court to get orders to coercively feed patients with anorexia.

Mr Justice Peter Kelly said the specialist, with "good justification", perceived a defect in the Mental Health Act.

This led to a "cumbersome" situation, where feeding orders have to be sought from the court, with "adverse" consequences for some.

The specialist expects feeding order applications to rise as new eating disorder services come on-stream here, and said some patients felt distressed and ashamed about being the subject of court orders to coercively feed them.

The Mental Health Act, unlike in several other jurisdictions, does not specifically address a situation where a patient refuses to be fed via naso-gastric tube. Restraint guidelines set by the Mental Health Commission continue to be regarded as preventing coercive feeding without court permission, she outlined.

Mr Justice Kelly said he hoped she would get an opportunity to make known her views about the need for changes in the law to allow for such treatment to be administered without court intervention.

The issue was raised when the judge was dealing with the case of a young woman with a long history of anorexia, psychiatric illness and depression.

Last month, he made orders permitting the woman to be detained in hospital and tube-fed after being told she had not eaten for a week and had made two serious suicide attempts.

Yesterday, the judge was told the woman had received a range of treatments and had made such a "miraculous" physical and psychiatric recovery that various medical reports had concluded she now had the capacity to make decisions about her health.

In those circumstances, the judge granted Paul Brady BL, for the HSE, an order discontinuing wardship proceedings.

The judge noted the woman had said in a "beautifully written" letter to him: "I want to live."

Irish Independent

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