Family fights medics’ view on resuscitation

The President of the High Court has expressed sympathy to the parents of a brain injured man at the centre of proceedings over whether doctors are entitled not to resuscitate him if his condition deteriorates.

Mr Justice Peter Kelly said he could not attempt to understand what the parents were going through but wanted to extended his sympathy concerning their plight as far as he could and would give them a full opportunity to consider medical evidence in the matter.

The parents disagree with doctors in relation to their son’s ability to communicate, the court heard.

In his 30s, their son has been on a ventilator for four years with a very poor prognosis. His treating doctors say he has irreversible brain injury and they consider, if his condition continues to deteriorate, further interventions will be futile and will only add to his suffering.

The HSE last July initiated proceedings aimed at allowing doctors decide against further interventions.

As the man was made a ward of court, the decision on whether doctors will make the final decision about his treatment rests with the court. The case is essentially about whether there is a right to withhold treatment considered by treating doctors as futile and not in his best interests.

Doctors also want the court to approve the putting in place of an appropriate care plan to move the man from the high dependency unit where he has been for some years to an alternative care environment such as another ward or hospice.

His parents, who have taken separate proceedings against the HSE alleging their son’s injuries arose as a result of medical negligence, want to retain the full resuscitation measures available to their son in the HDU and, because of that, do not want him moved from there.

Yesterday, Mr Justice Kelly adjourned the case to early December to facilitate consideration of medical reports being provided by the HSE and to allow the parents consider if they want to get additional reports.

Earlier, Peter Finlay, for the HSE, told the judge clinicians treating the man want to examine a video before making a final determination about confirming his state of minimal consciousness. If that is confirmed, the team will want the HSE application to proceed, he said.

Patricia Hill, for the parents, said if the case proceeds, they want orders to have it heard in camera.

The judge, who previously made the usual order in such cases directing nothing be published to identify the man, said he would deal with the in camera application at the appropriate stage. It was clear from sworn statements by the parents, handed to him to read, they do not agree with the orders being sought by the HSE, he noted.

Ms Hill said the parents took a different position from the doctors concerning their son’s ability to communicate. She said her clients had sought additional reports from the HSE when the case was before the court last July and received those. In reply to the judge, she said they had not instructed any other medical expert and she could not say at this point whether that would be done.

If the parents obtained medical reports contradicting the existing reports, there would have to be a hearing based on oral evidence to address the conflict, the judge said.

Mr Finlay said a further report from an anaesthetist was awaited and a report from an doctor who was independent of the man’s clinical team was sought. The clinicians were also available to the parents to address any queries, he added.