AT THE end of yesterday's judgment at the High Court, Ms Justice Mary Laffoy said it would be "helpful" if guidance and assistance were put in place for hospitals where patients object to treatments.
She made five recommendations, saying it would be helpful:
l If every maternity hospital had documented guidelines for the management of obstetric haemorrhage in women who refuse blood transfusion.
"I note that there is a template in existence in the guidelines of the Rotunda Hospital, dated 11th May, 2006, which were put in evidence, but I express no view on their adequacy in relation to legal issues," Ms Justice Laffoy said.
l If the information sought when a woman is booking into a maternity hospital specifically addressed whether the patient would accept a blood transfusion in the case of emergency.
If the Medical Council guidelines specifically addressed how capacity to give a valid refusal to medical treatment is to be assessed; and, given the inevitability that it will arise in the future, the issues which may arise relating to implementing the guidelines after refusal of medical treatment.
l If, pending the implementation of the recommendations of the Law Reform Commission in legislative form, the State were to designate a legal officer to perform functions of the type performed by the official solicitor in England and Wales in relation to patients who refuse medical treatment where an issue as to capacity arises.
l If a practice direction were put in place in the High Court setting out the procedure to be followed in relation to urgent applications in case of medical emergencies for authority to administer blood transfusions and other medical procedures, distinguishing the three situations which may arise:
(a) where an adult patient is incompetent;
(b) where the patient is a minor and the parents are refusing consent, and;
(c) where the patient is an adult and competent, but a doubt arises as to his or her capacity to refuse treatment.