High Court rules that doctors should not amputate an elderly Irish man’s leg – TheLiberal.ie – Our News, Your Views

High Court rules that doctors should not amputate an elderly Irish man’s leg




The High Court has ruled that doctors should not amputate an elderly man’s leg against his will, even though he is likely to die if the operation is not carried out.

In what the President of the High Court described as a difficult and complex case, the court ruled that the man could be allowed to look after his family at home.

Judge David Barniville will issue a full written judgment at a later date addressing the legal issues involved. He said, however, that he intends to announce his decision tonight, immediately after the hearing, due to the urgency of the case, reports RTE.

The case went to court because the man has dementia and is unable to make an informed decision. However, he has repeatedly expressed his wish not to have his leg amputated and earlier this week he addressed the court via video conference from his hospital bed and told the judge that he did not need the operation and that he would be scared.

The judge said it was a privilege to be able to speak directly to the man earlier this week as he was the “most important person” in the case, reports RTE.

Last month, the court ruled that the amputation did not need to go ahead, but it later emerged that there were disagreements between the medical team. A consultant surgeon told the court earlier this week that the man’s condition had changed and he was at increased risk of sudden bleeding, meaning care homes were unwilling to take responsibility and no palliative care plan had been set up.

The surgeon contradicted the opinions of geriatricians and psychiatrists, who said that amputating a leg against the man’s will would result in “Catastrophic mental distress”, reports RTE.

However, a palliative care consultant told the court today that comprehensive measures could be taken to care for the man at home, which he would prefer, or in a nursing home.

A detailed plan was quickly drawn up to support his family with daily care and in the event of a sudden fatal hemorrhage.

The court was told that the family were now ready to look after the man at home if the court ruled that the operation should not be carried out, provided there was a clear plan.

The family had previously expressed their wish for the amputation to continue, assuming the man might be resilient enough to deal with it.

Barry O’Donnell, the court-appointed attorney for the guardian, said it was her view that the operation should not go ahead given the evidence, including the man’s complex medical condition and that doctors said the 50% mortality rate in the first. 30 days after the operation.

The man, in his 70s, lives in a remote place but has been in hospital since the middle of last year, reports RTE.

He has acute peripheral vascular disease as a result of poorly controlled type 2 diabetes and when he was first admitted to hospital he was in imminent danger of losing one of his legs.

The doctors performed an operation to transplant his leg and they managed to save the limb. However, the court found that the man underwent significant surgery on his wounds due to his dementia, applying butter and jam.

It is now infected and doctors believe the man’s leg is irreparable.

The court was told that the man was at risk of bleeding if the graft ruptured. If he bleeds like that, he could die within 20 minutes.

Addressing the court via video from hospital on Tuesday, the man told President of the High Court Mr Justice David Barniville there was “no point in going around with one leg,” and “wouldn’t be going anywhere”, reports RTE

A consultant psychiatrist, who specialises in older people said: “This man is such a character, he is a force of nature and he says what he feels and wants and makes no bones about it. It is important for those of us who work with older people to made sure they don’t lose autonomy…just because they have dementia it does not always mean that what you have to say isn’t very valid and even though he doesn’t meet the test for capacity, his vehemently expressed view that he needs to have his leg is a very convincing factor to take into account here,” reports RTE.

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