The High Court has directed that K.W. be returned from St. Andrews in Northampton to Ireland on 8 July 2015, where she will become a voluntary patient. The direction was made in an ex tempore judgment by Mr Justice Noonan on 7 July, after the court reconsidered earlier orders in light of new medical evidence.
The Health Service Executive had initially asked the court to release it from an earlier direction to return K.W. to Ireland and to continue her detention in England. At the hearing, however, the HSE no longer sought that relief. It instead sought an agreed order for her immediate return as a voluntary patient.
In March, the High Court had found that K.W. lacked capacity to make decisions about her care and treatment, and ordered her return to Ireland for involuntary detention in Ennis. The HSE appealed the detention direction. In June, the Court of Appeal stayed the return order pending the High Court’s consideration of the HSE’s later motion.
Mr Justice Noonan heard updated evidence from treating psychiatrist Dr Iankov, K.W., and psychiatrists Dr O’Mahoney, Professor Brendan Kelly and Professor Harry Kennedy. Their views differed on the degree and fluctuation of K.W.’s capacity. The judge concluded that, on the preponderance of the medical evidence, she had legal capacity to decide about her care and treatment at that time. He held that the court had no continuing jurisdiction to detain her involuntarily on an ongoing and indefinite basis, but could manage a transition from detention to voluntary care.
The judgment described K.W.’s history of self-harm and the risks involved in her care. Professor Kelly considered prolonged detention potentially harmful and identified a possible treatment option in Ireland; the judgment did not make a finding that this option had been selected. The judge said her return should happen in a controlled and safe manner to protect her constitutional rights, including her right to life.
K.W. had told the court she earnestly wished to attend her father’s imminent wedding. The judge treated this as an informed decision by an adult with capacity and directed St. Andrews staff to keep her in detention until her care was handed over to HSE staff at Cork Airport on 8 July. She would then be a voluntary patient, with arrangements to transfer her overnight to Ennis psychiatric hospital and provide staff to accompany her to the wedding.
The judge gave the parties a short opportunity to consider the judgment and report their agreed arrangements before he made a formal order. The judgment therefore sets out the court’s directions and intended transition, while the formal order remained to follow.