Judge hopes ruling on treatment of boy may also help determine law for others

A Supreme Court judge has expressed hope the court’s decision on an appeal by the parents of a profoundly brain-injured boy concerning his medical treatment will find the right solution for him and determine the law for others who find themselves in similarly difficult and tragic situations.

Mr Justice Donal O’Donnell said a central issue for decision concerns the circumstances in which the State, through any mechanism, can take a decision contrary to one parents have conscientiously taken regarding the care of their child.

He made the observation during a case management hearing on Friday when he fixed December 15th for hearing the parents’ appeal against a High Court decision granting a hospital orders concerning his treatment.

The hospital says the boy, a ward of court referred to as John, has no hope of making any meaningful recovery from catastrophic injuries sustained in a road accident last summer.

It sought the “contingency orders” so it can treat him as it considers clinically and ethically appropriate, including by administering pain-relieving medications for dystonia, a movement disorder which, unless fully controlled by medication, causes his muscles to contract uncontrollably. The parents, who are separated, are concerned those medications can trigger respiratory distress.

They are also concerned the hospital wishes to withhold invasive interventions such as CPR should his condition substantially deteriorate and be effectively allowed to administer a palliative care regime. They want their son to receive any treatment that will keep him alive.

The Supreme Court has agreed to hear a “leapfrog” appeal, one directly to the court rather than the Court of Appeal, over the High Court orders.

High Court president Ms Justice Mary Irvine last month found John could experience “unimaginable suffering” unless the hospital can manage his condition as it considers appropriate. She concluded the orders, including taking John into wardship, were in his best interests and necessary to vindicate his rights. The parents’ love for their son has blinded them to the reality of his condition, she said.

The Attorney General and Irish Human Rights and Equality Commission were, at the request of the Supreme Court, put on notice of the appeal which raises important issues relating to the rights of the child, of parents and the threshold for intervention by the courts and the State with those rights.

Both were represented during Friday’s case management hearing and will be involved in the appeal.

Mr Justice O’Donnell said the case is “very tragic” with everyone involved trying to do the right thing by reference to their own understanding of the situation and their own positions.

The court is very concerned to achieve the right solution in this case for John, his parents and the hospital, and with a view to determining what the law is for other people who find themselves in difficult and tragic situations, he said.

The judge was told John’s condition has not deteriorated since October and there has been no recurrence of dystonia but the hospital remains concerned that the situation which the orders are intended to address could occur at any stage.

Having stressed the importance of addressing the issues in a “professional and focused” manner, and heard the parties views on a range of matters, he fixed the hearing for December 15th.