A seriously anorexic woman, who is likely to pass away without Nasogastric (NG) feeding and limitations on her independence, has expressed to the High Court via video conference from her hospital bed, her feelings of losing autonomy over her life and her desire to rediscover herself. The woman, in her 50s, with a long-term history of anorexia, is unable to be named due to legal considerations, and is currently an inpatient at a psychiatric department within a specified hospital, in accord with the Mental Health Act 2001.
The court was informed that upon her hospital admission in July, her weight was 36kg and her body mass index was 14, levels classified as ‘dangerously low’ in anorexia nervosa cases as per World Health Organisation standards. On July 24th, in an ex-parte (representation of one party only) proceeding, an application was made to the High Court for emergency orders to commence treatments such as NG feeding, oversight for purging, restriction on movement to prevent ‘micro exercising’ and control on fluid consumption. The approval for these treatments was confirmed at a complete trial on July 31st.
On the following Wednesday, Donal McGuinness, legal counsel for the HSE, maintained that the woman’s wellbeing was still greatly at risk. Her BMI remains at 14 and her weight under 36kg, with her continuing to resist certain treatments. Without the court’s approval for the orders, he stated, it is uncertain that the woman would receive the crucial nourishment she needs and undoubtedly her life would be immediately in peril. The possibility of her death is very probable, he stressed.
Emma Slattery, legal counsel for woman’s appointed Guardian ad Litem, submitted a report from a psychologist unaffiliated with the HSE, who found the woman fearfully avoided food, lacked understanding concerning her ailment, leading to the conclusion that there was no other option but to endorse the requests made by the HSE.
Mr Justice Heslin emphasised that the woman held the most significance in his courtroom. When he enquired about her perspective on the requested mandates, her response was a desperate plea to live, expressing confusion at how else she could communicate her distress to the judge. She expressed gratitude for the assistance provided and a longing to rediscover her true self rather than her current, anorexic, state. She requested a date of cessation for the mandates.
She spoke of feelings of guilt, seeing herself as undeserving, and occupying a valuable bed that should be given to someone in worse health. She confessed her longing for her family, her canine companion and the life she once had. Her words were a desperate cry for help.
Upon agreeing to her requests, Mr Justice Heslin assured her that no one else was more worthy of the bed she was in. He expressed gratitude for her articulate and clear contribution to the court proceedings. He stated that any limitations on her freedom should not exceed what was necessary for effective treatment, and should be reduced as soon as her health improved.