A young woman admitted to a hospital last month in an advanced state of malnutrition due to severe anorexia nervosa is “stable but critical”, the High Court in Dublin has heard.
Mr Justice Peter Kelly, president of the court, continued orders for the detention and treatment of the woman.
The 18-year-old, who had refused consent to the treatment, including tube refeeding, is in a “stable but critical” condition, Mr Justice Kelly was told by Mairead McKenna BL, for the HSE.
Given the medical and psychiatric evidence, there can be “no question” of releasing the woman, the judge said.
He noted a medical visitor appointed by the court to assess the woman’s capacity to make decisions on treatment in her best interests had expressed the opinion the woman is of unsound mind and lacks capacity to make appropriate judgments about treatment.
The evidence is the woman is stable but critical, is still being tube-fed, has no interest in ordinary food and no insight into the seriousness of her condition, he said.
Two-week adjournment
He granted Ms McKenna’s application for a two-week adjournment to facilitate the continued treatment and allow for further processing of an application to have the woman made a ward of court. He also continued orders for her detention and administrations of all treatments considered necessary in her best interests.
Mark Dunne, for the woman’s court-appointed guardian, agreed with the orders.
Previously, the judge noted the evidence was the woman would die of malnutrition unless she gets the treatment. “It is not a question that she might, she will,” he said.
When admitted to hospital last month, her body weight was about 40kg, with an extremely low body mass index, and her teeth were falling out. The judge was told she had been living on tea and cigarettes for some three months, has several siblings and limited family supports.
While she had been involved with adolescent mental health services in her native county, she was discharged from those services earlier last month, the court also heard. Her family GP was very concerned about her and referred her to a hospital in another county considered to have expertise in dealing with anorexia.
Emergency court orders
When her mother brought her to that hospital, she was immediately admitted and assessed and, after she refused to consent to treatment, the HSE secured emergency court orders permitting that. The orders were made under the court’s inherent jurisdiction and pending an application to have her made a ward of court.
The woman may have to be moved to the UK for specialist treatment as there are no suitable specialist facilities here for treatment-resistant anorexia, Mr Justice Kelly previously observed.
