The High Court has refused an application to continue an injunction preventing the Health Service Executive and Dr Peter Whitty from administering depot antipsychotic medication to a detained patient or restraining him for that purpose. The decision concerns interim relief; the patient’s underlying legal challenge remains for determination.
The patient, identified in the judgment as EC, is detained involuntarily in the Acute Psychiatric Unit at Tallaght University Hospital. He is challenging treatment with depot medication without what he says is a lawful procedure for assessing capacity, as well as the use of physical restraint to administer it. The proceedings also seek declarations concerning the Mental Health Act and constitutional and European Convention rights, a permanent injunction and damages. Those claims were not decided in this application.
The judgment records that EC refused oral medication, apart from one occasion, and refused depot injections. He was restrained and given clopixol injections on 15 and 22 December 2022. Dr Whitty’s affidavit said he assessed EC’s capacity before the injections and concluded he could not consent. The judge did not resolve a dispute about whether Dr Whitty carried out assessments on particular dates; she considered that issue unnecessary to decide at this interlocutory stage. She proceeded on the basis of Professor Kelly’s uncontested capacity assessment. The plaintiff did not contest the clinical opinion that he lacked capacity.
The HSE and Dr Whitty argued that delaying medication was contributing to a deterioration in EC’s condition, including increased aggression and distress, and could prolong his hospital treatment. The plaintiff’s counsel argued that treatment and restraint without a proper legal determination of capacity infringed his rights. No medical evidence was submitted to challenge the clinicians’ evidence about the need for treatment or to establish additional medical harm from treatment or restraint.
Justice Niamh Hyland accepted that there was a fair issue to be tried and that damages would not be an adequate remedy. Applying the balance of justice, she concluded that the risks of withholding treatment outweighed the asserted risk of unlawful treatment pending trial. She also considered that the court’s involvement provided independent oversight of the capacity conclusion for the interim period. On restraint, she said the hospital was applying its own policy and approaching restraint as if the relevant Mental Health Commission code applied, so safeguards were being used in practice.
The judge refused further interlocutory relief and lifted the existing injunction. She did not decide whether the treatment or restraint was ultimately lawful, or determine the patient’s substantive claims.