The High Court has authorised the transfer of a 20-year-old woman, identified in the judgment as Ms W, to a specialist eating disorder hospital in London for treatment and detention pending further court order.
In an ex tempore judgment delivered on 16 November 2022, Ms Justice Niamh Hyland found that Ms W lacked capacity in relation to decisions about her eating disorder. The court was exercising its protective wardship jurisdiction, although no wardship inquiry had yet been held and Ms W had not been made a Ward of Court.
The application, brought by notice of motion dated 10 November, sought authority for the transfer and for treatment without Ms W’s consent, including nasogastric feeding and, if necessary, other feeding methods. The court heard evidence from treating psychiatrists and an independent medical visitor. The independent visitor concluded that Ms W could retain and communicate information but could not fully understand or weigh relevant information about her illness and treatment.
The judgment records that Ms W had been in hospital for 60 days. Her weight had fallen after periods of home leave, and the treating psychiatrist said the general hospital had not been able to achieve and maintain weight restoration or provide the specialist care required. Evidence before the court was that the specialist hospital had accepted Ms W and would provide multidisciplinary inpatient treatment. The judge also considered a report identifying areas of care at that hospital that needed improvement, including facilities for nasogastric feeding; she was told those facilities had since been addressed.
Ms W’s position on the transfer had varied. The judge said that, at the hearing, she was willing to go, though she had reservations. The court gave significant weight to evidence that her complex needs could not be met by mental health services in Ireland, while recognising that treatment abroad would make family contact more difficult.
The court authorised nasogastric feeding and made the other orders sought under paragraphs 3 to 6, 7 to 13, and 14 to 17 of the notice of motion, subject to specified limits. It refused to authorise PEG feeding or total parenteral nutrition (TPN), finding insufficient evidence that those measures were necessary. The judge said the parties could apply to the court if those measures became necessary.
The order also requires regular intensive welfare reviews during Ms W’s detention so the court can assess whether there remains a basis for continued treatment. The judge said she would hear submissions on the review date; the judgment does not record that date.