Judge orders hospital to give transfusion


A Dublin maternity hospital was directed by the High Court yesterday to do everything in its power to save the life of a Jehovah's Witness facing death from massive blood loss following the birth of her baby boy.

Mr Justice Henry Abbott told Dr Chris Fitzpatrick, master of the Coombe maternity hospital, that staff could restrain the mother if she physically attempted to stop doctors administering a life-saving blood transfusion and clotting agent.

Restraint, he said, was a common feature of medical treatment.

Gerard Hogan, SC, told the court during an emergency lunchtime sitting, that the mother, identified as Ms K from the Republic of Congo, had suffered a massive haemorrhage following a difficult first delivery between 9am and 9.45am yesterday.

"While the child would appear to be in good shape and in sound medical condition, Ms K has lost a very considerable portion of her blood, estimated between 75 and 80 per cent, and is likely to die very shortly and at best within a matter of hours unless a transfusion and all associated medical procedures are authorised by the court," Mr Hogan said. He told Mr Justice Abbott that the mother was fully compos mentis and had informed the hospital authorities that she was a Jehovah's Witness and for personal and religious reasons had consciously made a decision refusing a blood transfusion.

Mr Hogan said that up until this the hospital had understood that Ms K, whose only language was French, was a Catholic.

He told Mr Justice Abbott there were a number of legal authorities relating to the court having taken decisions and having made orders which transcended the religious beliefs of parents in similar cases involving children.

He said he was not aware of any previous case in which a court had made such a decision in a case involving an adult where the adult was fully compos mentis and had consciously made a decision refusing medical intervention.

Mr Justice Abbott said he would always take the side of life rather than death and would deal with the application on the basis of Ms K being before the court on a stretcher and objecting to the application and telling him not to make the order.

Mr Hogan said the jurisdiction of the court to sanction medical intervention as far as a child was concerned was not in doubt or if the adult was in an unconscious state. The closest the Supreme Court or the High Court had previously come to making such a decision was in cases which had been determined on the basis of being in the interests of the child.

The most recent judgment which had put the welfare of the child foremost, over-riding the claimed constitutional rights and interests of its natural and married parents, was the judgment last week of Mr Justice John MacMenamin in which he had refused to return the child, Ann, to its natural parents from its prospective adoptive parents.

"I would respectfully say that, faced with the difficulties in which we are in this matter, there is a real risk that unless the court now does intervene the patient will slip into an irreversible coma and the baby will be left with no person in this country, as far as is known, to look after its welfare."

Mr Hogan submitted that the court could have regard to the welfare of the child and direct that the conscientious, sincere and respectfully held religious views of the mother could be overborne in its interests.

A blood transfusion, while intrusive, was a standard routine medical procedure and it was not as if the court was being asked to sanction surgery or some experimental treatment the patient would have to undergo.

He said Ms K may resist and he would ask that any order of the court should include a direction to the hospital to physically restrain the patient.

Mr Justice Abbott said there was a risk to the life of the mother and an imminent threat to the genuine welfare of the child and he felt the court could and should intervene in such circumstances.