By Ruth Mercer
The High Court authorised doctors to withdraw life-sustaining treatment from a 51-year-old ward of court after two consultant intensivists agreed that she had suffered a devastating and irreversible brain injury and would never regain consciousness.
The urgent application was brought by the Health Service Executive in relation to SM, whose identity is protected. Mr Justice David Barniville, President of the High Court, delivered judgment on 5 December 2025.
SM had been admitted to St Vincent’s University Hospital with respiratory problems on 4 November and returned to her residential placement on 21 November. In the early hours of 25 November she suffered a cardiac arrest and received CPR for about 53 minutes before being taken back to hospital. Tests identified blood clots in both lungs, and she later suffered another cardiac arrest in hospital.
The court heard that extensive neurological testing showed a severe hypoxic brain injury caused by lack of oxygen. SM remained deeply comatose and unresponsive without sedation. Consultant intensivist Dr Andrew Westbrook said she would never recover consciousness and that continued ventilation, artificial feeding and other invasive support would only prolong the inevitable.
An independent second opinion from consultant intensivist Dr Fiona Roberts reached the same conclusion. SM’s mother was aware of and supported the HSE application.
Mr Justice Barniville said the legal question was what was in SM’s best interests, taking account of her constitutional rights to life, bodily integrity, privacy, self-determination and dignity. He concluded that continued active treatment offered no positive benefit and authorised its withdrawal and a move to palliative care.
The ruling determined the treatment decision and also imposed reporting restrictions protecting SM’s identity. A postscript records that, after the judgment was delivered, the court was informed that SM had died.