No life-saving intervention for child
She will receive palliative care but should she require cardiac resuscitation, surgery, artificial ventilation, or general anaesthesia, doctors have been given permission to follow their clinical judgment not to provide such aggressive treatment.
Her doctor wants her to be able to return to residential care, which has been her home for most of her life, where she can live out her last days in comfort and peace.
The court heard she was admitted to hospital at four months of age with serious brain damage and has been in State care almost since then.
She is profoundly intellectually disabled and unable to communicate verbally, although she smiles when happy and cries when unhappy. She cannot be fed orally and lacks any capacity to look after herself.
She uses a wheelchair, suffers from severe spastic quadriplegia, epilepsy, scoliosis, a congenital heart condition, and suffers recurrent life-threatening infections.
She had been happy in residential care, attended a special school, and enjoyed music. Last year, she made her First Communion and went on holiday.
Her mother, who attended court, supported the doctors but said that as part of her palliative care programme, she should not be “pumped full of morphine unnecessarily”.
Her father has not been involved in her life to any great extent, was aware of the court application, but expressed no view on it.
Ms Justice Iseult O’Malley said the hospital had sought the order on the basis that it is highly unlikely she will recover from her condition. Even if she does she will have an extremely poor quality of life and will inevitably face another life-threatening event in the near future, the court heard.
In coming to her decision in “such a terribly difficult case”, the judge said she was obliged to act in the child’s best interests.
This includes taking account of her current illness, the length and quality of life she could expect, and the suffering inherent in the current course of treatment or in any possible future aggressive treatment, she said.
She was also taking into account the views of doctors and her parents.
The judge said it was not for her to impose her own views as to whether potential quality of life would be tolerable but to ask what would the child do if she were in a position to make a sound judgment.
There is a strong presumption in favour of life-saving treatment and the courts will never authorise positive steps to accelerate death or terminate life. However, in exceptional circumstances, authorisation may be given that steps not be taken to prolong life.
The court heard the child is not in pain other than when procedures are carried out.
