The president of the High Court has made orders permitting a child to undergo emergency treatment and surgery if necessary before next Wednesday despite his parents objections.
The parents appear to be “excellent” parents whose objections are not based on religious or ideological grounds but because they do not accept their son’s diagnosis or that he is as ill as his doctors maintain, Mr Justice Peter Kelly noted.
The HSE sought the interim orders on Thursday pending a full hearing next Wednesday to decide whether the proposed surgery for the boy, aged almost seven, is necessary.
That full hearing was directed after the boy was last week made a ward of court on an emergency basis due to medical concerns for the boy.
The orders granted on Thursday mean various treatments, including surgery to address an obstruction in the boy’s urethra considered the cause of recurrent infections, can be performed if an emergency situation arises before Wednesday.
The parents are also required to bring the child to hospital early next week for various tests and examinations.
On Thursday, Mr Justice Kelly accepted, if an emergency arises and the surgery is performed, next week’s hearing will effectively be redundant but he considered the orders are necessary in the child’s best interests.
The situation is not ideal but it “is not an ideal world” and he had tried to give the parents “as much due process as I can”, having discussed the situation with them last week and giving them an opportunity to get legal advice, he said.
The boy has been treated for consistent urethra problems, including urinary tract infections, since he was several months old.
His treating team say there has been a deterioration in the past 18 months in renal appearance, renal bloods and bladder functioning and, unless there is surgical intervention to address this, the child will suffer irreversible damage and may also suffer blindness.
He has a urethra catheter in place which doctors wanted to remove that this week and replace with a more comfortable one.
Arising from the court proceedings, that removal has been deferred to a date in mid-July considered to be the latest possible date for safe removal but doctors are now permitted remove it before then if an emergency arises.
Mr Justice Kelly noted the parents, from another EU country, have several other children and have been described as having an very good relationship with their children. The father has very good English but the mother does not, he said.
They appear to have been in contact with persons in their home country including a medical person who is not a paediatrican or urologist, he also noted.
Referring to evidence concerning the risks posed to a child by administration of a general anaesthetic, the judge noted the boy is in the middle range of risk. The interim orders, if they require to be given effect to before Wednesday, could mean the child would have one general anaesthetic rather than two, he noted.
An independent doctor appointed by the court to assess the child will also meet the parents this weekend to discuss the situation and he hoped that might result in the removal of their objections, the judge added.
Earlier, in seeking the emergency orders, Paul Brady BL, for the HSE, said doctors considered those were necessary if an emergency arose before next week’s hearing. What was involved was a “difficult balancing act” between giving the parents an opportunity to get legal advice and not prejudicing the child’s welfare.
The judge thanked David Hickey, a solicitor, for agreeing to advise the parents pro bono at short notice.
Mr Hickey said he had limited instructions and was concerned he had just received papers for this application that morning and the main treating doctor was not available to give evidence on this application.
The interim orders, if given effect to, will mean next week’s hearing would be redundant and it was not said anywhere the issues of concern would arise between now and Wednesday, he said.
Having heard the sides, the judge said he considered the orders were necessary in the child’s best interests and noted they would only be acted on in an emergency.
