On Thursday, the High Court head found himself in a complex situation of having to revoke orders that had improved a young lady’s ability to decline medical care. Last week, Mr Justice David Barniville granted permission for medical professionals to administer nutrition to the woman via a nasogastric tube, utilising the High Court’s inherent authority as she had lost mental competency due to malnutrition and food deprivation.
The implemented orders were successful, enabling her through tube feeding to regain sufficient competency to consent or reject healthcare procedures. However, the woman, currently hospitalised, declared agreement to the tube feeding only while authorized by court and would dismiss it if the court order was withdrawn.
Mr Justice Barniville expressed his limitations, as his authority does not extend to prolonging the nasogastric feeding orders without her approval, particularly now that medical reports confirm her regained mental fitness. He acknowledged being in a perplexing impasse, as the tube feeding, crucial for her survival, could be required over and over again due to her fluctuating mental state.
While Mr Justice Barniville expressed the situation as exceedingly challenging and distressing for everyone involved, he clarified that he had authorised the initial orders the week prior, requested by the Health Service Executive, and represented by legal practitioner, Ciara Dowd. On Thursday, Ms Dowd expressed no intention to extend the tube feeding orders, supported by the fact that the woman had regained her mental capacity.
However, Ms Dowd highlighted the risk of the woman, once again, losing her mental capacity due to food restrictions provoking cognitive impairments. She maintained that continued collaboration with a designated representative, tasked with communicating the woman’s best interests to the court, remains in her favour.
Aligned with this view, Natalie McDonnell, representative for the court-appointed advocate, confirmed the court’s maximum course of action on Thursday would be to revoke the feeding orders while preserving her client’s standing.
Mr Justice Barniville further indicated that parties could urgently return to court if the woman consents to the orders, instructing not to delay over the weekend if such circumstances emerged. In the absence of consent, a review of the case can be expected before him on the following Monday.
He furthermore conveyed his distress about the woman’s “grave” and “unstable” conditions, due to her location, she effectively has no access to psychiatric treatment. He voiced his hope that the HSE would take urgent actions to support her.
Ms Dowd stated that a consultant psychiatrist had attended to her this week and she intends to relay his message to her client.
The judge retracted the orders for nasogastric feeding.
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