A judge has made orders allowing doctors administer life-saving treatment to a young woman in an advanced state of malnutrition due to anorexia nervosa after she refused consent to the treatment
The 18-year-old remains seriously ill in intensive care and the evidence is she will die of malnutrition unless she gets the treatment, the president of the High Court, Mr Justice Peter Kelly said.
“Without that, she will die. It is not a question that she might, she will.”
Her body weight is about 40kg with an extremely low Body Mass Index, her teeth are falling out and, in line with the classic symptoms of severe anorexia, she has demonstrated no insight into the seriousness of her condition, he noted.
Mr Justice Kelly was told the woman had been living on tea and cigarettes for some three months. It was also stated she has several siblings and there are limited family supports.
While she had been involved with adolescent mental health services in her native county, she was discharged from those services this month, the court was told. Her family GP was very concerned about her and referred her to a hospital in another county considered to have expertise in dealing with anorexia.
When her mother brought her to that hospital on Friday, she was immediately admitted and assessed and, after she refused to consent to treatment, the HSE sought court orders permitting that be administered.
The orders were made by Mr Justice Henry Abbott at an emergency court sitting on Saturday evening under the court’s inherent jurisdiction and pending an application to have her made a ward of court.
Lacks capacity
The judge was satisfied that from the evidence before him, the woman lacked capacity to consent to treatment in her best interests.
The case was returned to Mr Justice Kelly on Monday when he was asked by Maireád McKenna BL, for the HSE, to continue the treatment orders.
The situation remains “critical”, counsel said. The woman is lightly sedated, is on refeeding treatment and is stable in intensive care but is likely to have to remain there for weeks.
Mr Justice Abbott had also appointed a guardian to represent the woman’s interests who has visited her in hospital, the court heard.
Mark Dunne BL, for the guardian, supported the orders. The woman has little insight into her condition and had asked to leave hospital today, he said.
In his ruling, Mr Justice Kelly said the evidence indicated this was an appropriate case for wardship and he would direct the woman’s capacity be assessed by a court medical visitor.
Pending a decision on wardship, he would continue the treatment and detention orders as the evidence is the woman is seriously ill and will die of malnutrition without intensive medical intervention, he said.
The woman may also have to be moved to the UK for specialist treatment as there are no suitable specialist facilities here for treatment resistant anorexia, which may be the form of anorexia in this case, he added.
