High Court President visits severely brain-injured man before making ventilator support decision

High Court President visits severely brain-injured man before making ventilator support decision
Library pic of Mr Justice Peter Kelly

The President of the High Court has visited a severely brain injured man in hospital before reserving his decision on the HSE's application to allow doctors not to resuscitate the man or increase his ventilator support if his condition deteriorates.

Mr Justice Peter Kelly said he would deliver judgment as soon as he can. Because he has "very profound questions" to address and a "great deal to read and think about", this was not a matter to be rushed, he said.

Addressing the man's parents, who oppose the HSE's application and maintain he has a significant level of awareness, the judge said they certainly fit into the category of "devoted and responsible parents".

He thanked them for attending court, co-operating with his visit to their son and for their care for their son over the years.

He also expressed thanks to the hospital authorities for facilitating his recent visit.

The parents are separately suing the HSE on the man's behalf arising form his care and treatment after he was admitted to hospital with an acute lung conditioon.

The court has heard there is no unifying diagnosis for the man’s injuries. He suffered a significant brain injury some months after his admission to hospital where he remains in a high dependency unit.

The HSE application is not about withdrawing existing ventilation or other treatments but giving doctors discretion, if the man suffers a setback, not to apply CPR or increase ventilator support if they consider such treatment is not beneficial.

Doctors consider his condition has deteriorated over the past two years and will not improve but his parents disagree on that and other issues including his ability to communicate.

Because the man, aged in his 30s, has been made a ward of court, Mr Justice Kelly must decide whether or not the orders are in his best interests. He heard final legal submissions in the case this week after which he reserved judgment.

In closing arguments, Peter Finlay SC, for the HSE, said there was an area of dispute concerning whether or not a doctor shoud be forced to do something against their judgment or ethics and whether life should be maintained at any cost.

Doctors who gave evidence expressed concerns, for example, that administering CPR or extra ventilation to the man might cause further suffering without improving his overall condition and could involve acting against their better judgment.

Patricia Hill BL, for the parents, said one of the man's treating doctor, when asked if she would resusictate him if he could communicate such a wish to her, had said she would "respect his opinion".

The HSE side had not explained why the existing ventilator support was the correct level and there should be no more, she argued. The man previously came through two instances of infection after increased ventilation and returned to the quality of life he currently has. Increasing ventilator support was not equivalent to asking the court to give him life "at any cost".

In evidence previously, the man's father told the judge: "I want him to be kept alive. Where there’s life, there’s hope."

Asked did he believe his son gets enjoyment from life, he said he did. "I can see emotion, I can see happiness from time to time."

"When the time comes for him to leave this world, it should come naturally and with the full support a civil and caring society can offer."


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