Courts

Mentally-ill woman subject to emergency court order responding well to cancer treatment, judge told

Homeless woman (50s) lacked capacity to give consent for urgent chemotherapy to treat cancerous tumour on chest

While the woman is well physically, she is 'not welcoming' of any psychiatric treatment.

Fri Jul 28 2023 - 19:38

A mentally ill woman who was the subject of an emergency court order to have a life-threatening cancerous tumour on her chest treated has responded well to the treatment, the president of the High Court was told on Friday.

Last month, Mr Justice David Barniville sat in emergency session at 7am to deal with an application from the HSE for an order allowing the immediate administration of chemotherapy to the woman after she presented at a hospital in what the court heard were “dire” circumstances.

The tumour, a B-cell lymphoma, had grown to such an extent that her lungs were overwhelmed and saturation was at a critical level, Donal McGuinness BL, for the HSE said.

The woman, who is a foreign national in her 50s and has been homeless, lacked capacity to give consent for the treatment which resulted in the court application.

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Mr McGuinness said the treatment started later on the day the order was made and since then there has been a “dramatic improvement” in her physical health.

However, counsel said, she still lacked capacity and he was seeking a continuation of the orders the court had granted allowing for treatments, including for her mental health, to continue.

Counsel said the court order had saved her life and she continues to improve physically but it seems that an underlying schizoaffective disorder she suffers from is treatment resistant.

While she is in a physical condition to be discharged and continue to receive treatment for her cancer on an outpatient basis, she still requires treatment at an approved centre for her mental illness, he said. Unfortunately, she is “not welcoming” of any psychiatric treatment, he said.

It is anticipated that she will be moved to an appropriate mental health facility as soon as a bed becomes available, he said.

The woman’s court-appointed guardian told the judge she had a fear of being transferred to a psychiatric ward because of past experience in psychiatric units in another country.

She also said she wanted to return to a city where she had lived for the longest time and, it appeared, in different hostels.

Mr Justice Barniville said her progress had been “pretty remarkable when you think of where we were in June”.

However there had been no real improvement in her mental health and the application before the court was to transfer her to an appropriate centre so this can be continued and that treatment for her physical condition can be on an outpatient basis.

She had declined to engage with the psychiatric services and continues to display bizarre behaviour, he said. She lacked capacity in relation to her situation and it is agreed she would be very much at risk without a continuing court order.

He was satisfied therefore to make an order that whatever centre she goes to she can be detained there.

As she is likely not to go voluntarily the transfer can be done with the assistance of a HSE-assisted admissions team, he said.

The case comes back for review in October.

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