Benevolent Paternalism or a Clash of Values: Motherhood and Refusal of Medical Treatment in Ireland

Kay Wilson,Penelope Weller

doi:10.19164/ijmhcl.v0i21.238

Abstract

Fitzpatrick v. K [2008] IEHC 104 (25 April 2008) (H.Ct) (Ir.)

Highlights

The recent decision of the Irish High Court in Fitzpatrick is both a typical and an extraordinary case
It is typical in that it reflects a long line of refusal of treatment cases in England that illustrate the reluctance of the courts to respect a patient’s choice where the outcome of the decision is unpalatable.[5]. It is extraordinary because (i) it arises from unique facts where the outcome of the patient’s decision was emotive; (ii) the failure of the patient to take into account the interests of a third party was deemed a critical factor in the judicial finding of a lack of capacity;[6] and (iii) it displays a willingness by the Court to require that ‘capacity’ is demonstrated by a high level of understanding
At the plenary hearing the High Court affirmed that patient autonomy is a right protected by Irish law, but validated the ex parte order to administer a blood transfusion on the basis that the patient lacked capacity

Summary

Introduction

The recent decision of the Irish High Court in Fitzpatrick is both a typical and an extraordinary case. Ms Justice Laffoy found that the patient was not a competent adult and upheld the ex parte order based on the patient’s lack of capacity. Irish commentators noted that the ex parte order in Fitzpatrick “would find little supporting jurisprudence in modern jurisprudence in other jurisdictions.”[11] They argued that the decision could not be justified by the constitutional obligation of the State to defend the rights of the unborn (Article 40.3.3), because the patient’s baby was born so that her decision to refuse blood threatened her own life but not her baby’s.12. At the plenary hearing the High Court affirmed that patient autonomy is a right protected by Irish law, but validated the ex parte order to administer a blood transfusion on the basis that the patient lacked capacity. The paper concludes with a consideration of the implications of the decision

Facts and Judgment

Discussion

Findings

Future Implications

Conclusion