The High Court has authorised compulsory medical treatment for a prisoner serving a life sentence after he repeatedly injured his neck and refused medication while being treated at an anonymised hospital.
The defendant, identified as C.D., was serving a life sentence for murder in Wheatfield Prison when he was admitted to Hospital X on August 8, 2016 following a self-inflicted neck injury. The wound was not healing and the judgment records that he refused prescribed medication and inflicted further injuries on himself.
Hospital staff considered intravenous antibiotics immediately necessary because of the risk of sepsis. They also believed sedation might be required if he became uncooperative. He was awaiting transfer to the Central Mental Hospital.
A psychiatric report raised concerns about paranoid thinking and a possible psychotic condition and concluded that he lacked capacity to consent to proposed treatment. However, Mr Justice Richard Humphreys said the evidence of incapacity was not sufficiently detailed that he would have been comfortable relying on it alone to compel treatment.
The judge therefore considered the separate issue of whether a prisoner of full mental capacity could refuse life-saving treatment.
He held that a prisoner cannot use refusal of medical care, food or hydration to frustrate a lawful sentence. In his view, rights to autonomy, privacy and bodily integrity are qualified by imprisonment to the extent necessary to prevent self-harm that would defeat the court's order.
The ruling authorised Hospital X to provide all treatment recommended for the prisoner's medical welfare, including surgery, sedation and necessary force. Hospital staff could also seek assistance from the Irish Prison Service or Gardaí.
The court refused to hear the case entirely in private, finding that anonymising the parties and hospital sufficiently protected the interests involved. A solicitor was appointed as guardian ad litem to represent the prisoner's interests during the application.