Parents oppose HSE orders not to resuscitate son

A mother who is opposing the HSE’s application for “do not resuscitate” orders for her severely brain injured son has told the High Court she and her husband love their son and want him to live but not to “suffer”.

“I don’t want him to suffer, I know he has suffered enough.”

The last time her son spoke to her was more than four years ago when he was admitted to hospital vomiting blood, she said.

The man, aged in his 30s, underwent a lung surgery procedure and remained in hospital. He suffered a brain injury some months later and has been in a hospital high dependency unit since.

His mother says he responds to conversation and stimuli and she has seen him smile and cry. She had seen tears roll down his cheek and did not consider that was “watery eye”.

She believes he watches TV and is a fan of singer Nathan Carter and particularly liked the song Wagon Wheel.

She considered he had favourites among his nurses and visitors and said, on one occasion, he kept his eyes closed when a particular person visited while she was also there and opened them when told the visitor had left.

Very good care

She and her husband loved their son, believe he has suffered a lot but has improved over the past year. He appeared more relaxed, was getting very good care from staff and she would like that to continue.

She was giving evidence in the continuing hearing before the president of the High Court, Mr Justice Peter Kelly, of the HSE’s application for orders allowing doctors not resuscitate the man if his condition deteriorates.

Because the man is a ward of court, the judge must decide whether or not those orders are in his best interests.

The parents are opposing the orders. They have separate medical negligence proceedings against the HSE arising from his treatment following his admission to hospital.

On Thursday, the judge told the mother he would do his “level best to make the right decision” and he was very sorry she and her husband were in this position. “No one would want to be.”

In response to Peter Finlay SC, for the HSE, the woman said she appreciated her son suffered a bit when he is ventilated but said he had always pulled through in the past.

Asked did she want his life to continue, she said she did but did not want him to suffer.

She agreed the evidence of his treating team is they cannot see an improvement in recent years such as to convince them certain treatments such as cardio pulmonary resuscitation (CPR) would be beneficial if he deteriorated.

Mr Finlay said the doctors believe, if a crisis occurs, they should not give him more ventilation just so he could stay alive. He asked the mother her view, adding that was “a hard question” for any parent to answer.

The mother replied: “I know it can’t be easy, they are more medically minded than I am, much more, but . . .”

Honest and fair

When her voice trailed off, Mr Finlay said he would not persist. He said the doctors were themselves upset but the issue was, if they considered certain treatment was not fair, whether that was an honest and fair opinion.

Liam Reidy SC, for the parents, said they wanted the court to make that decision.

Mr Justice Kelly said his decision “is very hard” and those most involved were the parents. He said to the mother the doctors’ concerns include that administering CPR could lead to a rib fracture. The mother said she would not like to see that happen but believed her son would return to the position he was in before any such setback.

Earlier, the judge watched a video recording of the man’s response to assessment by a neuropsychologist who is among a number of medical experts who have provided reports on the man’s current state and prognosis.

The psychologist considered the man is in a minimally conscious state who could and does respond to commands and stimuli. Some responses appeared to require a “Herculean effort” and the man could not speak for reasons including he has a permanent tracheostomy. He considered the man has disorders of consciousness but not locked-in syndrome.

There is no facility in Ireland that will provide rehabilitation to a person who requires ventilation, he said. He also considered it was a “reasonable proposition” the man may experience pain from some treatments.

The case continues.