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Four Courts

Doctors told they can withdraw life support for clinically dead pregnant woman

The High Court made its judgement this afternoon.

THE HIGH COURT has ruled that the life support for a clinically dead pregnant woman can be withdrawn – at the discretion of her medical team.

The judgement was handed down by Justice Nicholas Kearns at noon today and will not be appealed. Lawyers for the unborn said the interest’s of the child were sufficiently considered by the court in its ruling.

The court had been asked by the HSE to issue a declaration that discontinuing treatment for the woman would be lawful.

Justice Kearns said that the court “is satisfied, in the circumstances of this case, that in the best interest of the unborn child, it should authorise at the discretion of the medical team the withdrawal of ongoing somatic support being provided… in this tragic and unfortunate case”.

It will accordingly make a declaration and order to that effect.

Representatives for the unborn had initially argued against the move, stating that the right to life was greater than the right to dignity in death.

The woman’s family – and the father of the unborn – wished for the current treatment to be stopped so they could lay her to rest.

In his judgement, Justice Kearns said to “maintain and continue the present somatic support for the mother would deprive her of dignity in death and subject her father, her partner and her young children to unimaginable distress in a futile exercise which commenced only because of fears held by treating medical specialists of potential consequences”.

The woman, who is in her mid-20s, was declared dead on 3 December when she was 15 weeks pregnant and doctors said they needed legal clarification on what they were allowed to do because of the 8th Amendment.

The High Court had been told there was “no reasonable” prospect the baby would be born alive. It is currently at 17-18 weeks gestation.

The three-judge panel noted that the court accepts the evidence of the medical witnesses that “from a medical viewpoint… there is no real prospect of maintaining stability in the uterine environment, having regard to the degree of infection, the fluctuating temperatures in the body of the mother, the difficulty in maintaining a safe blood pressure and the amount of toxic medication being administered to the mother which is not licenced for pregnancy”.

End of proceedings

As no appeal will be lodged by representatives for the unborn or for the mother, Justice Kearns said he hopes the family will be given some comfort now that court proceedings have come to an end.

Costs will be paid by the Court for both sides given the case raised issues of “great public importance”.

The court also paid tribute to the woman’s father and partner for their “immense courage and fortitude in dealing with the catastrophe”, one that was compounded by having to come to court to give evidence.

It has been an enormous family tragedy, involving a young woman in the prime of life, who was undoubtedly looking forward to the successful outcome of her pregnancy.

He also said that the somatic support being provided is being maintained at a “hugely destructive cost to both her remains and to the feelings and sensitivities  of her family and loved ones”.

The condition of the mother is failing at such a rate and to such a degree that it will not be possible for the pregnancy to progress much further or to a point where any form of live birth will be possible.

As one doctor put it, the unborn child is not yet in distress but it is facing into a “perfect storm” from which is has no realistic prospect of emerging alive.

It has nothing but distress and death in prospect.

8th Amendment

Kearns also reiterated his belief that this was not an abortion case. He emphasised that the court’s view was not influenced to any degree by any consideration “that if the unborn child were to be born alive, it might nonetheless be impaired to a greater or lesser degree”.

This is not a case where the Court on the evidence is required to consider that possibility. This case turns on its own particular facts which are centred entirely on whether the unborn child can survive at all.

It found that the child will not be born alive, and that is the basis for the ruling.

“The Court is further satisfied on the evidence that, in addition to the ongoing trauma and suffering experienced by the family though the continuance of somatic support, such continuing support will cause distress to the unborn child in circumstances where it has no genuine prospect of being born alive.

“It would be a distressing exercise in futility for the unborn child,” the judgement continues.

That consideration is important when it comes to considering what in this case is in the best interest of the unborn child.

Commenting after the case, Health Minister Leo Varadkar said, ”I wish to convey my heartfelt sympathies to the family and partner of the woman at the centre of this case at this most difficult time – particularly given the season.

“This case and the judgement will need to be carefully examined before I can make any further comment on it. In the meantime, I would ask that the privacy of this family is respected, at this so difficult and challenging time.”

First published 1.54pm 

Read: Court told ‘right to life of unborn’ greater than ‘right to dignity in death’

More: Case of clinically dead pregnant woman back in the High Court today

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