The law should allow families of loved ones in a persistent vegetative state, and their doctors, to withdraw artificial nutrition in a "timely and agreed" manner, the High Court has been told.
When there is no dispute such withdrawal is appropriate, families and the Health Service Executive should not have to go to the High Court for the relevant orders, Gerard Durcan SC, for Patricia Hickey, the general solicitor for wards of court, said.
The Supreme Court, in its recent judgment in the JJ case concerning a boy in a minimally conscious state, has set out the law in such a way that now can happen, he said.
The Medical Council’s ethical guidelines mean it is not unlawful for doctors to discontinue artificial nutrition/hydration for those in a persistent vegetative state, he noted.
He was making submissions on an application by the mother of a young woman, aged in her 20s and in a persistent vegetative state for 10 years, for orders stopping artificial nutrition/hydration so she can have a “natural and dignified” death.
The mother wants the court to order that withdrawal of treatment would not involve unlawful actions by doctors and, if necessary, providing the court’s consent for such withdrawal and the associated administration of a palliative care regime.
When the case concluded on Friday after a three-day hearing, High Court president Ms Justice Mary Irvine said she hoped to give judgment within six weeks.
The judge said it was a privilege to meet this family and thanked them for giving her a picture of the young woman and the past “extraordinary” 10 years. The mother is among “many remarkable mothers who rear families in such difficult circumstances”, she added.
The woman suffered severe brain injury in summer 2011 following several cardiac arrests. Doctors agree she has no prospect of recovery or improvement. She was made a ward of court last year.
The HSE and the general solicitor, appointed to represent the woman’s interests in wardship, support the mother’s application as in the woman’s best interests.
Her mother and sister have given evidence and the family, clearly distressed, have been in court throughout the hearing.
During submissions on Friday, Mr Durcan said this was a “very, very sad case” but it may be of some comfort to the family if the court’s judgment helps clarify things for other families in similar circumstances.
When he thanked Ms Justice Irvine for her compassionate handling of the case, the judge said managing wardship is the “singular most important” role she has as president of the High Court and it was her privilege to come into contact with “remarkable” people such as this family.
Donal McGuinness SC, for the HSE, said the “compelling” evidence was that it is in the woman’s best interests to discontinue the peg feeding and hydration.
The treatment is futile, will not lead to recovery and, in any event, there is no prospect of recovery, he said. The woman’s life is being artificially maintained in a way that is undignified and does not have proper regard to her constitutional right to bodily integrity.
Her constitutional right to life includes a right to die a natural and dignified death and the peg treatment is inhibiting that right, he said.
