An elderly woman with dementia who recently lost the ability to swallow but is otherwise healthy has been discharged from hospital with a treatment plan which will involve her being “starved to death”, the High Court heard.
Having been told the 81-year-old woman has not eaten for 14 days, the President of the High Court, Mr Justice Peter Kelly, directed an urgent inquiry - to be heard Tuesday - into whether the proposed treatment is medically justifiable, or if the woman should receive the normal treatment for her condition, namely percutaneous endoscopic gastrostomy (PEG) feeding via a tube into her stomach.
The woman’s GP had said in a letter to the hospital consultant involved that she, the GP, was “not comfortable ethically” with the proposed palliative care treatment, the judge noted.
The woman is “not imminently terminal” and, if the hospital’s plan of action for her care is continued, the cause of her death would be “from lack of feeding”, the doctor said. “I am not comfortable ethically to be part of this care.”
The GP also said, if the proposed treatment decision was made as part of a multidisciplinary assessment, then she, the GP, could not override that “but I would need this in writing and to clearly state this”.
The hospital note “does not state anything re no PEG and the implications of this non-treatment”, she added.
The woman has had no food for 12 days after a consultant at the hospital said she was unsuitable for feeding via a tube into her stomach, the court heard. She is on a glucose drip and her family are very concerned about her, it was stated.
Mr Justice Kelly said the matter must be addressed urgently as the woman has had no food for 14 days and no one would be in good condition if they were in the same position.
He directed either the HSE or hospital should attend a court hearing on Tuesday to determine if the hospital’s plan is medically justified or if, as her family suggest, the woman should be instead fed via a tube into her stomach. He would also be happy to hear from the woman’s family and GP, the judge added.
The woman is a ward of court and solicitor Andrew Cody, representing the concerns of the woman’s daughter, who constitutes her wardship committee, had raised the situation with the court. Neither the woman nor hospital may be identified by court order.
Mr Cody said the woman is a resident of a nursing home and has Alzheimer’s disease but is otherwise in reasonably good health.
He said she was treated in hospital about two weeks ago for aspirational pneumonia with swallowing difficulties. After some ten days of tests, she was diagnosed as having suffered a minor stroke, resulting in her losing her ability to swallow, a condition that will not improve, he said.
Her family were later informed she was to be discharged. They were told the normal treatment for the lost ability to swallow was PEG feeding, feeding via tube into the stomach, but that was not considered appropriate in her case for several reasons, including her age, the fact she has Alzheimer’s, risks of possible infection and that she might pull out the tube.
The woman was discharged with a plan for palliative care, Mr Cody said. This was despite her family saying she was “sitting up discussing recipes for tarts”.
Her GP was disturbed by the proposed treatment and had voiced concerns that, in effect, the woman “is to be starved to death”, he said.
The family did not want their mother starved to death and, while they knew the PEG treatment involved risks, wanted that treatment, he said.
