Court orders life-saving transfusion


A life-saving blood transfusion was administered to a critically ill baby under a court order secured by a Dublin hospital at a late night court hearing in a High Court judge's home after the child's parents, members of the Jehovah Witness faith, objected on religious grounds to the procedure, it has emerged.

The baby boy, who became very unwell on Christmas Day and whose condition continued to deteriorate, received the transfusion shortly after a hearing which concluded at 2.30am on December 27th in Mr Justice Gerard Hogan's home, the judge revealed today.

The child's condition has improved since and he is no longer critically ill, the court heard.

Mr Justice Hogan today outlined his reasons for granting the Children's University Hospital at Temple Street, Dublin, an order allowing the transfusion. He also made orders preventing identification of the child.

While conscious of the constitutional requirement that justice be administered in public, save in exceptional circumstances as prescribed by law, he said a public hearing was impossible in the circumstances of this case but he was delivering judgment in open court.

The baby boy was born in autumn 2010 but his twin sister died. The boy became very unwell due to acute bronchiolitis on Christmas Day. His condition deteriorated further that day and at at one point, he stopped breathing and had to be resuscitated. He also had a hypoxic episode - a period of low oxygenation - which had "potentially ominous implications".

The baby was transferred from another hospital to Temple Street early on December 26th, and his situation was critical early that evening. Already with low haemoglobin, he experienced a further drop in the level of haemoglobin due to his illness that significantly hindered his body's capacity to deliver oxygen to his vital organs and maintain normal neurological functions. Evidence was given his liver was somewhat distended.

The judge said the usual trigger for a blood transfusion is where haemoglobin levels drop below a certain point. By 9pm on December 26th, a transfusion was "absolutely necessary".

While the child's parents were clearly anxious for his welfare and sought the best medical care, they, as committed Jehovah Witnesses, completely opposed a transfusion, although they had consented to the use of certain blood products earlier that day.

The hospital decided to seek a court order allowing it administer a transfusion, and an emergency hearing was held in the judge's house at 1am on December 27th, concluding at 2.30am.

Doctors told the judge the baby's life was in danger and there was no medical alternative to a transfusion. The parents told him they wanted the best for their child but, on religious grounds, could not consent to a transfusion. The court had previously sanctioned a transfusion for another child of the parents, and they seemed resigned it would order one, the judge noted.

The parents struck him as "wholesome and upright" and most anxious for their child's welfare yet steadfast in their religious beliefs, the judge said. An abhorrence of the administration of blood products was integral to those beliefs.

The Constitution guarantees freedom of conscience and the free practice of religion, he said. It also gives parents the right to raise their children by reference to their own religious and philosophical views but that right was not absolute.

The State has a vital interest in ensuring that children are protected and that interest can prevail even in the face of express and fundamental constitutional rights, he said.

The right of the State to intervene and override the constitutional right of parents was expressly circumscribed by Article 42.5 which provided for such intervention only in exceptional circumstances. Such intervention must be proportionate to the circumstances and there must have been a "failure" of duty on the part of parents.

While the use of the term "failure" was "somewhat unhappy" in this case where the parents, acting according to their deeply held religious views, behaved in a conscientious fashion vis a vis their child, the test whether they had failed was an objective one judged by the secular standards of society in general and the Constitution in particular.

While most Irish people might express unease and even disdain for a religious belief which requires its faithful to abjure an often life-saving and essential medical treatment, the Witnesses regarded the blood prohibition as ordained by scripture and posing a practical test of their faith, he said.

There was absolutely no doubt the court can intervene in a case such as this were the child' life, general welfare and other vital interests are at stake, he said.

Given the constitutional requirement for the State to protect by its laws the life and person of every citizen, it was "incontestable" the court has a jurisdiction, "and indeed a duty", to override the religious objections of the parents where adherence to these beliefs would threaten the life and general welfare of their child, he ruled. On that basis, it was lawful for the hospital to administer a transfusion and other blood products to this baby.