Mr Justice Nicholas Kearns, President of the High Court, made the order on 28th May 2014 after hearing that the woman’s medical condition was life threatening. A young woman described as being at “grave risk” of malnutrition and irreversible liver injury due to severe anorexia is to be fed through a nasogastric tube against her wishes.
Evidence was heard that her treating psychiatrist believed that, although an articulate young woman, she does not have the necessary mental capacity to recognise the seriousness of the position due to anorexia and does not have the capacity to make appropriate decisions. The court heard evidence that she was capable of understanding information and communicating her wishes but was incapable of weighing up the information. Evidence was heard that the woman did not accept she was in denial and did not think she would die if she refused further nutrition leading to weight restoration. She believed that doctors were trying to overfeed her.
This woman’s case was considered “at the most severe end” of the scale on anorexia and other feeding options suggested by the woman, including oral supplements and peg feeding, would not work. It was noted by Doctors treating woman that she has suffered from eating disorders since aged 12. The Court was advised that they believe that the feeding treatment is vital to safeguard her life and health and to ensure she is taken out of “grave danger”. Counsel told the court that a nasogastric tube had been inserted previously but that the woman had ripped it out.
This application was made because it was considered in the woman’s best interests and was a measure of last resort for the HSE. They indicated to the court that they were aware how serious it was to ask the court to intervene. Before this application the woman had access to all the treatment options available, including in the UK. Her parents are involved in her care and actively supported the application. This was indicated by the woman’s father to the President in court who also indicated that he thought regular reviews would give her something to work towards.
Mr Justice Nicholas Kearns noted that was not the first such case to come before him and, upon hearing the evidence adduced by both sides, he made the orders sought. The Orders allow for tube feeding of the woman and whatever other medical procedures are deemed necessary, including the use of restraints if necessary to do so.
The matter would be subject to regular review and mater is next returnable before the court on 5th June 2014 and a further psychiatric review is to take place.