‘Grotesque’ to keep woman on life support

To continue life support treatment for a corpse in order to sustain the unlikely viability of an unborn baby in its womb would be going "from the extraordinary to the grotesque," the High Court was told yesterday.

The statement was made by Peter McKenna, consultant obstetrician at the Rotunda Hospital, when he was giving expert evidence to a three-judge division of the court hearing an application for the discontinuance of life support for the “deceased” mother.

The woman in her 20s, who cannot be identified for legal reasons, was referred to several times in the day-long hearing as “brain dead”, deceased, “a corpse”, and “like a dead body”.

The court heard, at one point, the body had make-up applied to the face for the purpose of a visit by her two children who had been brought to see her before she “joined the angels”.

The Divisional Court, consisting of Mr Justice Nicholas Kearns, Ms Justice Marie Baker and Ms Justice Caroline Costello, will give its decision on St Stephen’s Day after hearing oral legal submissions today.

There was no reasonable prospect of survival for the unborn child of the woman, who was declared clinically dead on December 3, when the baby was at 14 weeks gestation, the court heard.

Mr McKenna, who is not associated with the Dublin hospital in which she died or the hospital where she is receiving life support treatment, said if the fatal brain trauma suffered by the mother had happened at 24 weeks gestation, he would try to sustain the pregnancy for a couple of weeks in order to deliver the baby.

“I think the picture painted of the patient here today is such that further progress of the pregnancy is becoming increasingly unlikely,” he said. “I would be firmly of the view that the appropriate decision now is not to continue with the support.”

He said he totally agreed they were talking about an extraordinary case and what he had heard in court about the patient’s current treatment, it would be going from the extraordinary to the grotesque to continue with it.

An obstetrician leading the medical team treating the woman said he would have great concern about the unborn’s chance of survival. The woman’s ongoing evolving condition seemed to be getting worse daily.

He had been told when the patient had been moved from Dublin to the country hospital, she was brain dead and had to be kept alive because she was pregnant. “I don’t see much hope for her continuing in the condition she is in. I honestly don’t think there is any hope of the baby surviving.”

The doctor, whose identity might identify the dead woman or the hospital in which she is being treated, said she was deteriorating rapidly. Infection had become overwhelming over the last few days and seemed to be getting worse.

“We have all the signs of a perfect storm and it is getting worse. To give the baby an opportunity of surviving, we must continue treatment as long as there is a heartbeat. We have to do what we must by law.”

Lawyers for the HSE told the court yesterday it was not practicable to vindicate any right to life of the unborn child and its decision was based on medical evidence. The HSE believed the appropriate declaration by the court was for the discontinuance of life support and that this was lawful in the circumstances.

The father of the pregnant woman said his daughter was dead and the family had been told the chances of the unborn was minimal. They wanted her to have dignity and be put to rest. The woman’s partner and father of the unborn child said he supported that view.

Brian Marsh, a consultant in intensive care, told the court that in his opinion the woman was not alive at any level. She had become a corpse and sustaining her was not feasible for a lengthy period of time. He said the unborn child would need to be brought to around 32 weeks gestation and he did not believe this possible. He did not believe the unborn could survive.

The court was told the woman had been admitted to hospital in late November suffering from headaches and vomiting. After falling on November 29, she had become unresponsive.

Following tests, her time of death had been recorded as 5.20pm on December 3.

Mr Justice Kearns adjourned the hearing until this morning to hear oral legal submissions.