Care regime for woman in coma for more than 40 days to continue until at least next week

Hospital and HSE want to remove mechanical ventilation to see if woman can breathe on her own

The woman has a breathing and cough reflex which is indicative of some brainstem function, the court heard. Photograph: Chris Maddaloni / Collins
The woman has a breathing and cough reflex which is indicative of some brainstem function, the court heard. Photograph: Chris Maddaloni / Collins

A woman who has been in a coma for more than 40 days after suffering a catastrophic brain injury in a road traffic accident will continue to be cared for until at least next week under a regime approved last week by the president of the High Court.

On Thursday, Mr Justice David Barniville agreed to the continuation of his order until the middle of next week so that expert reports on behalf of the woman’s family and her court-appointed guardian can be obtained and circulated.

The care regime was approved in circumstances where the hospital and the HSE want permission to remove some of the life supports, including mechanical ventilation, to see if she can breathe on her own. She has shown no improvement in more than 40 days.

She has a breathing and cough reflex which is indicative of some brainstem function, the court heard.

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The woman’s husband and son believe the supports should continue as long as there are signs of life.

The court was told last week that this was also in keeping with their religious and cultural beliefs.

The case was adjourned until this week to allow the family and the guardian to address the court before the judge considers an application to allow the hospital take the next steps, including ending mechanical ventilation.

When the case returned before Mr Justice Barniville on Thursday, Michael Lynn SC, for the family, said he required more time to get independent evidence to support their case. A consultant neurosurgeon will prepare a report after he has seen her over the weekend, he said.

Counsel said he would not necessarily say there is a cultural and religious aspect to the case but the family’s faith was the same as the neurosurgeon who will see her. Counsel said he had no doubt the doctor will be of assistance to the family.

David Leahy SC, for the guardian, supported Mr Lynn’s adjournment application as his side is having a report from an expert in intensive care medicine prepared. It will be available for circulation overnight or on Friday. Their expert would say whether advice from a neurologist was also required.

Donal McGuinness BL, for the hospital and the HSE, said his side’s position was that the medical evidence stated the continued prolonged intubation of the woman was not reasonable and was outside the standard of medical care.

Counsel said his side had agreed to continue the regime as it is to allow for discussion but the continuation of that scenario was unreasonable because it can give rise to significant difficulties with the development of complications in the patient. He accepted getting reports from the other experts may be of benefit.

Mr Justice Barniville said that if there was ongoing distress to the woman it was something that would have to be taken into account. But, having heard that she had not developed any of the possible complications so far, he was prepared to grant an adjournment.

The judge said he was amenable to putting the matter back to next week to allow the parties to assemble such independent medical evidence as they feel is appropriate. He also gave directions for the circulation of the reports before the case comes back.