The president of the High Court hopes to rule next week on a hospital’s application for orders allowing it to withhold invasive life preserving interventions from a catastrophically brain-injured child.
The orders, effectively providing for a palliative care regime, are sought because doctors believe the boy will not make any meaningful recovery from injuries suffered in a road collision during the summer and is in pain daily as a result of dystonia, which is incurable and will be lifelong.
Ms Justice Mary Irvine said on Tuesday, having heard legal submissions from all sides, that she hoped to rule next week on “this important case”.
Conor Dignam SC, for the hospital, said that while it accepts the collision happened just months ago, it considered the orders being sought in this “tragic and unfortunate” case are in the boy’s best interests.
His treating and other doctors all agree he is almost certainly in pain as a result of regular dystonic episodes and he will make no meaningful recovery from his injuries, counsel said.
One doctor considered his best prognosis was to move from a vegetative state to a minimally conscious state.
The fact the orders are being sought via the High Court’s wardship jurisdiction ensures the rights of all parties, including the boy and his parents, are protected, their views are heard and the legal test is what is in the boy’s best interests, counsel submitted.
Recovery prospects
Elizabeth Murphy SC, for the boy’s mother, opposed the application as “unprecedented” and premature, arguing it was made without an opportunity to adequately diagnose his recovery prospects from his injuries.
It is too early for the court to decide what is in the boy’s best interests and this application is seeking to evolve a new jurisdiction for the High Court in wardship, she argued.
The court cannot be influenced by what the hospital says about the boy’s pain or severe disability, she said. Pain is part of life and the solution to pain cannot be to shorten the boy’s life as to do so would mark “the thin end of the wedge”.
A Supreme Court decision prevented terminally ill Marie Fleming from legally taking her own life and third parties cannot legally shorten the lives of others, she argued.
Colin Smyth BL, for the boy’s father, opposed the application on grounds including the father considered it was being made too early. He wanted his son to have more time and believed the boy would not want his father to “give up on him”.
‘Fighter’
David Leahy BL, for the boy’s court appointed guardian, set out medical evidence and also noted evidence from the mother that her son would like to be cared for at home where he would have the company of his family and his dogs.
The mother described the boy as a “fighter” who would not give up on his recovery, counsel noted.
At the outset of the hearing last week, the judge granted the hospital’s application, brought in light of the difference of views between the parents and doctors concerning the boy’s treatment, to have him made a ward of court.
The wardship application was opposed by both parents and the effect of wardship is that the court, rather than the parents, will determine whether the orders sought are in the boy’s best interests.
During the hearing, a palliative critical care specialist said doctors have concerns about the potential for litigation given the disagreement with the parents about the treatment options for the boy and indicated that was among the reasons the orders were being sought.
