Judge cautions against 'paternalistic' treatment of families of wards of court

Ms Justice Mary Irvine said that lawyers, and doctors, can sometimes engage in 'paternalistic behaviour' in relation to thinking they know what is best for a child. File picture. 

The president of the High Court has expressed concern that families of some wards of court feel they are being “sidelined” by some “paternalistic” doctors and lawyers.

Ms Justice Mary Irvine, who runs the court’s wardship list, said she will consider whether the court can put some form of protocol in place to ensure families are involved and kept fully informed.

She made the remarks when reviewing the case of a 17-year-old girl with a long history of eating disorder who was diagnosed with anorexia nervosa when aged 11.

She was subject of an emergency wardship application by the HSE to the High Court in 2019. Then in hospital, her condition was so serious she was described as “critically unwell” with a BMI of 11.7.

Orders were made, with the consent of her parents, permitting her detention in hospital and treatment, including naso-gastric feeding, after the court was told she was in denial of the seriousness of her situation, insisting she felt “fine”, refusing bed rest, and “microexercising”.

Doctors expressed the view that, as a result of anorexia, she lacked capacity to understand the seriousness of her situation.

On Friday, Ms Justice Irvine was told the girl has made such good progress at a specialist eating disorders residential facility she is now in a position to go home.

'Bitterly disappointed'

The girl’s father earlier told the judge he and his wife felt they had not been kept fully informed about their daughter’s situation and were “bitterly disappointed” about that. They also felt no one had really explained the wardship process to them.

The judge said she was concerned he felt as he did.

Under the Constitution, it is assumed the family knows best and normally the State does not intervene, she said. Children have their own rights to be protected and sometimes the State has to step in, she said.

That did not mean parents can suddenly be sidelined, she said.

Lawyers, and doctors, can sometimes engage in “paternalistic behaviour” in relation to thinking they know what is best for a child, she said.

While not accepting there was any deliberate withholding of information from the man, she said doctors and lawyers sometimes forget “the whole human aspect” of situations and that should not happen.