THE HEALTH Service Executive is seeking a High Court order requiring that certain drugs be administered from birth to the child of a heavily pregnant HIV-positive woman with a view to reducing the risk of transmission of the virus.
The HSE says the Antiretroviral (ARV) prophylaxis medication, if administered from birth for a four- week period, will reduce the risk of transmission.
However, the woman, who the court heard, had accessed information about HIV and the drugs on the internet, has expressed concern the drugs pose risks to the child.
Her counsel Fergal Kavanagh said yesterday these were “black-label, highly toxic” drugs which had side-effects in some cases and had led to some deaths and their risks had to be “properly weighed”.
There was no conflict between the interests of the mother and child and, if it was determined it was in the child’s interests to be treated with the drugs, the mother would be happy with that, he said.
Felix McEnroy, for the HSE, said the case should be “reduced to common sense”.
The HSE says its evidence is that the ARV drugs reduce the risk of transmission of the HIV virus to a child to 0.01 per cent and, while the drugs can have side-effects, such risks are more than counter-balanced by the benefits of preventing HIV transmission.
The HSE wants the court order because it is concerned the woman was “in denial” of her diagnosis as HIV-positive and the implications of that for her child.
The woman had not adhered consistently to the medical advice concerning her treatment, including that she should have an elective Caesarean section this weekend, it said.
A further order restraining the woman breastfeeding the child, also with a view to reducing the risk of transmission of HIV, was initially sought by the HSE but the court was told yesterday the woman would give an undertaking not to breastfeed.
The woman, who is in the latter stages of pregnancy, is due to give birth at a Dublin maternity hospital.
The doctors involved in the woman’s care and treatment claim it is in the best interests of her unborn child to be delivered by elective Caesarean section (ECS) on Monday next rather than wait for either a natural birth or emergency CS.
International opinion is that elective CS carries fewer risks and leads to best outcomes for babies with HIV-positive mothers, a doctor told the court.
The woman has said she will not agree to an ECS on Monday but will have an ECS next Friday.
The woman wants the court in the interim to determine whether it is in the best interests of her child to have the ARV drugs administered.
Mr Justice George Birmingham has adjourned to today the further hearing of the HSE’s application so the woman’s lawyers have an opportunity to call evidence related to the safety of the drugs.
Earlier, Mr Kavanagh said the issue in the case had narrowed to whether the court could order administration of these drugs having conducted an investigation into their toxicology and pharmacology.
Counsel said the woman could not be forced to have the elective CS and the judge confirmed no order could be made requiring her to undergo such a procedure.
Mr Kavanagh said he had been instructed by the mother to rerpresent the child at this stage. His side wanted to call expert witnesses and would need time.
Mr Justice Birmingham told Mr Kavanagh the qualifications of the witnesses sought to be called would have to be established and asked was counsel proposing to call any medical witness “as opposed to people on the internet”.
