The Supreme Court has refused to compel two parents to allow their infant son to undergo a routine blood screening test despite finding their decision to refuse it was objectively unwise.
The North Western Health Board sought a mandatory order requiring the parents, identified as H.B. and C.B., to consent to a PKU test. The pinprick blood test screens newborns for metabolic conditions which can cause serious disability or life-threatening illness if undetected but can be treated when identified early.
The parents objected in principle to what they regarded as an invasive procedure. Their general standing as responsible and caring parents was not questioned. The evidence also established that, while the consequences of an undetected condition could be severe, any individual child was more likely than not to be free of the conditions being screened for.
The case required the Supreme Court to consider the balance between children's constitutional rights and the constitutionally protected authority and autonomy of the family.
Mr Justice Murray said parents have primary responsibility for their children's upbringing and welfare. The State can intervene in exceptional circumstances, including where parents fail in their duties towards a child. But it cannot simply replace a parental decision because the State or a court considers another choice objectively better.
He said allowing intervention whenever a parental decision appeared unwise would risk State or court micromanagement of family life. Intervention against parental wishes required something exceptional arising from a failure of duty, involving an immediate and fundamental threat to the child's capacity to function physically, morally or socially.
The judge described the parents' refusal as manifestly unwise and noted they had not provided a rational basis that would satisfy an objective observer. However, the child appeared healthy and was probably free of the relevant conditions. The refusal therefore did not amount to an abdication of parental responsibility sufficient to permit the State to override them.
The appeal was dismissed.