{"id":402905,"date":"2026-03-25T10:24:07","date_gmt":"2026-03-25T10:24:07","guid":{"rendered":"https:\/\/www.europesays.com\/ie\/402905\/"},"modified":"2026-03-25T10:24:07","modified_gmt":"2026-03-25T10:24:07","slug":"mentally-ill-womans-advanced-healthcare-directive-opposed-medication-even-if-life-at-risk-the-irish-times","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/ie\/402905\/","title":{"rendered":"Mentally ill woman\u2019s advanced healthcare directive opposed medication even if life at risk \u2013 The Irish Times"},"content":{"rendered":"

An advanced healthcare directive made by a mentally ill woman opposed her treatment with psychotropic drugs even if that step put her life at risk, the High Court<\/a> heard.<\/p>\n

The directive (AHD), and a dispute over whether the psychotropic medication is \u201clife-sustaining\u201d, is at the centre of an important case arising from an application by the HSE<\/a> to enable doctors to legally treat the woman with psychotropic medication.<\/p>\n

The middle-aged woman was diagnosed with a serious mental illness about 20 years ago. She made the AHD about six weeks before being involuntarily detained under the Mental Health Act (MHA) late last year in a psychiatric unit, after her condition relapsed. <\/p>\n

Her evidence was that she had gradually reduced her medication to about half previous levels at about the time she was involuntarily admitted.<\/p>\n

She remains detained under the MHA and is receiving treatment, including psychotropic medication, for her psychiatric illness and other treatment for some physical health conditions. Her physical and mental health state has improved, the court heard. <\/p>\n

The case raises complex legal issues concerning the interaction of provisions of the Assisted Decision-Making Capacity Act 2015 with the MHA, and the outcome has potentially significant implications.<\/p>\n

The issues include whether the woman\u2019s directive is \u201cvalid\u201d or \u201capplicable\u201d, whether the treatment that doctors wish to continue administering to her is \u201clife-sustaining\u201d, and whether the courts have jurisdiction to intervene.<\/p>\n

The two-day hearing concluded on Monday and Judge Conor Dignam said he hoped to deliver his decision within six weeks. <\/p>\n

The HSE has argued the woman\u2019s AHD is not valid because, it contends, the woman lacked capacity at the time she made it. It argues the medication is \u201clife-sustaining\u201d and that the woman\u2019s constitutional rights, including the right to life, mean the High Court can make orders overriding the directive.<\/p>\n

The court has heard the woman\u2019s treating psychiatrist, and an independent psychiatrist who assessed her on behalf of her court-appointed guardian, had formed the opinion she probably lacked capacity at the time she made the AHD. <\/p>\n

In submissions for the guardian on Monday, senior counsel Alan Brady said a guardian\u2019s role is to convey the \u201cwill and preference\u201d of the relevant person along with the guardian\u2019s independent view of that person\u2019s best interests.<\/p>\n

In this case, the woman was clear about her will and preferences, in that she did not regard the psychotropic medication as \u201clife-sustaining\u201d, he said. <\/p>\n

A core issue concerned whether the psychotropic medication was \u201clife-sustaining\u201d treatment, but the evidence did not establish that, Brady said. <\/p>\n

The evidence from her psychiatrist included that a manic episode would exacerbate the woman\u2019s physical ailments.<\/p>\n

Senior counsel Shane Murphy, for the Mental Health Commission, a notice party to the case, said its role was to assist the court. <\/p>\n

Counsel said the commission was concerned with the HSE\u2019s broad interpretation of \u201clife-sustaining\u201d in the context of AHDs and about arguments that there was no requirement of a link between the withdrawal of medication and death. <\/p>\n

The commission\u2019s position was that the HSE must show a failure to provide the medication would, at that time, mean a significant risk of death.<\/p>\n

The presumption of capacity in the 2015 Act is arguably the \u201cmost fundamental\u201d principle underpinning the Act, and the HSE had provided inadequate evidence to overturn that presumption, it was argued. <\/p>\n

It is open to the court to conclude the woman\u2019s clear will and preference in her AHD should be respected, it was submitted. Her expression of wishes was very much focused on the drugs, and the treatments available to alleviate mental distress is wider with alternatives such as restraints, seclusion and counselling, the commission said. <\/p>\n","protected":false},"excerpt":{"rendered":"An advanced healthcare directive made by a mentally ill woman opposed her treatment with psychotropic drugs even if…\n","protected":false},"author":2,"featured_media":337578,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_share_on_mastodon":"0"},"categories":[275],"tags":[159237,147351,18,135,475,474,19,17,462,26571,12777],"class_list":["post-402905","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-consultation","tag-desktop","tag-eire","tag-health","tag-health-care","tag-healthcare","tag-ie","tag-ireland","tag-medication","tag-physician","tag-practice"],"share_on_mastodon":{"url":"","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/402905","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/comments?post=402905"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/402905\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media\/337578"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media?parent=402905"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/categories?post=402905"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/tags?post=402905"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}