A High Court judge has said he can make no further orders in the case of an "extraordinarily vulnerable" woman who doctors fear may die due to her "enormous" alcohol consumption.
The woman, aged in her forties and with a troubled history, has been diagnosed with cirrhosis of the liver and has said she knows "it's life or death now" but is refusing to enter a rehabilitation programme to address her chronic alcoholism.
Because she has been deemed to have the necessary capacity to make decisions, then, however unwise others may think those are, he must respect that capacity and discharge her as a ward of court, Mr Justice Peter Kelly said.
While wishing the woman the best, he was pessimistic for her, he said. "It's not a good start to the new year."
The woman has been a ward of court for some years after receiving a six figure compensation sum arising from an unnecessary medical procedure performed on her when she was in her early twenties.
Her compensation was used to buy her a house, now said to be in a poor state due to her difficulties, and to try and address her alcoholism and only about €13,000 of the compensation remains. She also receives disability allowance.
Due to concerns for her life and health arising form excessive drinking and associated risky behaviour, Patricia Hickey, the general solicitor for wards of court, obtained orders from Mr Justice Kelly last month for the woman to be detained in hospital for detoxification, which was successful.
She was afterwards detained in a psychiatric unit over Christmas for reasons including she did not wish to return home as she was lonely and feared she would resume drinking.
The woman had admitted to sometimes drinking four bottles of vodka, plus beer, daily, the court heard.
The judge, while accepting the psychiatric unit was not appropriate, said it was better than her being discharged home and would help her stabilise. On foot of indications the woman has insight into her situation, he also directed a fresh assessment of her capacity to make decisions
On Thursday, he was told by Maria Dillon, solicitor for the HSE community services and Ms Hickey, the medical reports clearly state the woman has the necessary capacity.
Given that evidence, the judge said he must discharge the woman as a ward of court. He noted the detoxification and period in the psychiatric unit had been beneficial for the woman and said he was very grateful to all the staff who looked after her so well during this and earlier hospitalisations.
The evidence is the woman's future depends on her completing a rehabilitation programme and that had been arranged for her but she was refusing to participate, he said.
Because the evidence is she is of sound mind with capacity to make decisions, there was no legal basis for continuing her in wardship, he said.
While he would strongly urge the woman to co-operate with medical staff and others who have her welfare at heart, there was nothing more he could do, he said.
The woman is a sentient adult who can make up her own mind if she wants to get better or worse, he said. If she gets worse, that could have fatal consequences, he said.