HSE will not seek DNA sample while 'John Doe' patient is alive

Judge expresses concern about lack of care plan for unidentified elderly man who has been in a psychiatric hospital for over 30 years
HSE will not seek DNA sample while 'John Doe' patient is alive

The HSE has decided not to seek High Court orders permitting it take a DNA sample from an unidentified vulnerable elderly man while he is still alive.

Believed to be aged in his 80s or 90s, the man has been in a psychiatric hospital here for more than 30 years.

For reasons including that he previously indicated to hospital staff he does not wish to be identified, the HSE is not seeking to be permitted take a DNA sample, for the purpose of addressing posthumous procedures, while he is still alive, David Leahy BL, for the HSE, said.

Gardaí have informed the HSE that a DNA sample can be taken just as quickly after the man’s death, counsel outlined when the case was before High Court president Ms Justice Mary Irvine on Monday.

Mr Leahy also suggested an adjournment of the HSE’s application for orders permitting doctors to withhold interventions for the man should his condition deteriorate.

The judge expressed concern about the lack of detail in a care plan provided as part of the application for those orders.

She observed the plan, set out in a letter from the man’s treating psychiatrist, did not precisely state what was proposed should happen if, for example, the man sustained an infection or required CPR.

She returned the matter to July 5 for a more detailed care plan to be provided.

Ward of court

The man, who was made a ward of court last September, was first admitted to the psychiatric hospital after being taken there by gardaí in the mid 1980s. He was reported to be living “a hermit’s life” and sleeping rough in a bus shelter with a dog whom he said he had “on loan”. He also referred to living in Dublin "for years".

At some point after his admission, he was given a name and estimated date of birth of 1930. Despite some efforts to establish his true identity and find a next of kin, he essentially remains a 'John Doe'.

He has a history of mental illness, along with physical health conditions.

The wardship application was initiated in May 2020 because his physical health was deteriorating and he had had a number of hospital admissions. His clinical team considered it would not be appropriate to resuscitate him should his condition deteriorate further to a situation where resuscitation is required.

Rather than a further hospital admission, they said he should be made comfortable where he is.

The man had expressed a desire not to be sent to a general hospital should his condition deteriorate but doctors were concerned whether he had capacity to make decisions about his health and welfare and that any decision against resuscitation should have a legal basis.

Last September, on foot of an independent medical visitor's report and other medical evidence, the court said it was satisfied the man lacked capacity and should be taken into wardship.

His court appointed guardian reported that the man was incapable of giving expression to his views and appeared to have effectively made staff and other patients at the hospital his family.

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