{"id":573673,"date":"2026-07-29T11:21:07","date_gmt":"2026-07-29T11:21:07","guid":{"rendered":"https:\/\/www.newsbeep.com\/ie\/573673\/"},"modified":"2026-07-29T11:21:07","modified_gmt":"2026-07-29T11:21:07","slug":"mentally-ill-womans-advanced-healthcare-directive-ruled-invalid-by-high-court-the-irish-times","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ie\/573673\/","title":{"rendered":"Mentally ill woman\u2019s advanced healthcare directive ruled invalid by High Court \u2013 The Irish Times"},"content":{"rendered":"

A mentally ill woman\u2019s advanced healthcare directive opposing any treatment with psychotropic drugs even if that put her life at risk has been found invalid by the High Court<\/a>. <\/p>\n

Judge Conor Dignam made the finding in a significant judgment involving detailed consideration, for the first time, of relevant provisions of the Assisted Decision Making Capacity Act 2015 concerning binding advanced healthcare directives (AHDs).<\/p>\n

The psychiatric medication, in the particular circumstances of the woman\u2019s case, was \u201clife-sustaining treatment\u201d, he held.<\/p>\n

That finding meant the High Court had jurisdiction under the 2015 Act to hear the Health Service Executive<\/a>\u2019s application for a declaration that lack of capacity by the maker of such a directive is a ground upon which it may be declared invalid, he said.<\/p>\n

The evidence, including from the woman\u2019s parents, other relatives and medical reports, established that when the woman made her directive in November 2025 she lacked capacity, he found. As a result, he declared the directive to be invalid. <\/p>\n

Because the woman was discharged from hospital since the court hearing, it was not necessary to decide whether it was applicable, he said. <\/p>\n

The directive, and a dispute over whether the psychotropic medication was \u201clife-sustaining\u201d, was at the centre of proceedings by the HSE aimed at enabling doctors to legally treat the woman with psychotropic medication.<\/p>\n

The woman was a respondent to the proceedings and the Mental Health Commission was a notice party. <\/p>\n

The middle-aged woman was diagnosed with a serious mental illness about 20 years ago that required hospitalisation for periods in 2006, and in 2009, after she discontinued her psychiatric medication. After presenting for assessment in early 2023 at a hospital as a new patient, she had regular reviews. <\/p>\n

In early November 2025, she made her AHD stating she wanted no psychiatric medication. That was made just weeks before she was involuntarily detained, under the Mental Health Act, in a psychiatric unit after her condition relapsed. <\/p>\n

The evidence was that, against medical advice, she had gradually reduced her medication to about half around the time of relapse. <\/p>\n

In line with her AHD, no psychiatric medication was administered and she also refused consent to monitoring for her physical health conditions.<\/p>\n

The HSE took proceedings and the High Court in late January made orders permitting administration of such medical treatment as her treating doctors considered necessary to secure best treatment for her.<\/p>\n

At the time of the full hearing last March, she remained detained under the MHA and was receiving treatment for her psychiatric illness and for physical health conditions. Her physical and mental health state had improved, the court heard.<\/p>\n

Some weeks after the hearing, the court was told the woman had been discharged from hospital but all sides urged the judge to decide the legal issues.<\/p>\n

In his judgment published this week, Dignam said he had determined issues for reasons including the woman herself had requested a judgment and, if she suffered a relapse, the issue of validity of the AHD, or any new AHD, would have to be heard again. <\/p>\n

The case raised complex legal issues concerning the interaction of provisions of the 2015 Act with the Mental Health Act. <\/p>\n

Among his findings, Dignam said the Circuit Court had exclusive jurisdiction in respect of challenges to the validity or applicability of AHDs that did not involve considerations of life-sustaining treatment but the High Court had jurisdiction in cases that did involve such considerations. <\/p>\n

The 2015 Act did not define \u201clife-sustaining\u201d treatment, he noted. This was \u201cunfortunate\u201d but also probably reflected that the issue of whether treatment was life-sustaining would depend on the context and circumstances of an individual case. <\/p>\n

The context and circumstances may vary but would include that the treatment must be proposed for sustaining life and that its non-provision at the relevant time had to result in a risk of death that was \u201cnot notional, vague or general\u201d, he held.<\/p>\n

In the very particular context and circumstances of this case, he was satisfied the psychiatric medication was \u201clife-sustaining treatment\u201d. <\/p>\n

His finding that the woman lacked capacity in November 2025 when she made her AHD was based on evidence from her parents, other relatives and friends, and medical reports. <\/p>\n","protected":false},"excerpt":{"rendered":"A mentally ill woman\u2019s advanced healthcare directive opposing any treatment with psychotropic drugs even if that put her…\n","protected":false},"author":2,"featured_media":37157,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[103,1418,73,61,60,410,72503,411],"class_list":["post-573673","post","type-post","status-publish","format-standard","has-post-thumbnail","category-mental-health","tag-health","tag-health-service-executive-hse","tag-high-court","tag-ie","tag-ireland","tag-mental-health","tag-mental-health-commission","tag-mentalhealth"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/573673","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=573673"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/573673\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/37157"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=573673"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=573673"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=573673"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}