A hospital is seeking High Court orders permitting it to withhold invasive interventions and administer palliative care for a young boy who they believe has little prospect of a "meaningful" recovery after suffering a catastrophic brain injury in a car accident earlier this year.
The boy's parents oppose the orders, including ones that would allow the hospital not to resuscitate him in the event of cardiac arrest.
His doctors say such invasive interventions will not alter his prognosis, may cause him pain and distress and are not ethically justified.
The parents, who are estranged and separately represented, say the hospital's application is "unprecedented" and too early in the context of an accident which happened just a few months ago.
It is accepted their son is not brain-dead and the hospital should wait and see how his situation develops, they argue.
The mother's solicitor said the court cannot embark on assessing what exactly a "meaningful" recovery means or what constitutes "a meaningful or worthy life". She believes her son is making a slow improvement and will achieve a recovery "that could be considered a life".
Conor Dignam SC, for the hospital, said yesterday he was seeking the disputed orders in wardship proceedings. The parents opposed wardship.
He stressed there is no dispute about the parents' love and care for their son but, due to the disagreement with doctors about his future care, wardship was an appropriate mechanism for determining where his best interests lay.
High Court president Ms Justice Mary Irvine said she would admit the boy into wardship and give her reasons later.
A hearing to determine whether the orders sought by the hospital should be granted was then opened.
At the outset, the judge told the parents she had decided against visiting the boy in hospital because of the Covid-19 restrictions, his inability to communicate and because she did not want her decision influenced by her impressions of him as she lacked medical expertise.
Mr Dignam said a team of doctors involved in the boy's treatment support the orders.
He said the boy was on a ventilator for some weeks after the accident. He can now breathe unaided, which doctors expected because the part of his brain which controls breathing is unharmed, but is in a persistent state of disordered consciousness, does not respond to voice or commands and is fed through a tube.
The medical team believe his situation would not significantly improve, counsel said.
The mother's solicitor said the orders sought were unprecedented in this case as it concerned a patient with no diagnosis of a permanent vegetative state or brain death.
The application, just weeks after his accident, to discontinue active management and care was too soon and the child should get every opportunity to come to whatever recovery he can.
The case continues.