‘Feed her or she’ll die’

Woman who weighs just 5st 8lb can be force fed to save her life, judge rules

A BRIGHT college student who is at immediate risk of dying as a result of her anorexia can be tube-fed by doctors, a High Court judge has ruled.

The hospital where the young woman is being treated went to court yesterday, saying her condition was critical.

Peter Finlay SC, for the hospital, said she weighed just 36kg – 5st 8lb – and had a body mass index of 12 and a low pulse.

He said that although the student had no wish to die, she was unable to bring herself to take food voluntarily and had an ‘irrational’ fear of being fed through a nasal gastric tube.

The court heard that without careful treatment, the woman was at risk of imminent death from a cardiac arrest or from hypoglycaemia, which is low blood sugar.

‘Time is really against us,’ Mr Finlay said, adding: ‘If the situation was allowed to continue and the dramatic weight loss were to continue, there would be fatal consequences.’

The woman, in her 20s, cannot be identified, by court order.

The court heard that she was first diagnosed with anorexia nervosa in 2013 and had spent a number of periods in hospital or specialist centres for eating disorders since then.

This time, she was admitted to hospital six weeks ago.

Mr Finlay said that with the aid of her parents, she managed to make some progress and take oral supplements. But her condition deteriorated drastically over Christmas week and she began to lose weight again.

He described her as highly intelligent and articulate and well able to make her views known.

But while she understood that she had a serious illness, she was unable to understand that she was at risk of death.

Therefore, said Mr Finlay, she was incapable of managing her own affairs when it came to the necessity for a nasal gastric tube and the court had the power to intervene in such matters of life and death.

Counsel said the hospital unit she was in was highly experienced in such cases and dealt with around 14 patients a year who became critically ill through anorexia nervosa.

It typically struck highly gifted young women, occasionally men, and had the highest mortality rate of all psychiatric illnesses – at 30%.

Mr Finlay said the hospital was applying for the power to use nasal gastric tube feeding if necessary in the coming days. He hoped the order alone might help encourage the woman to eat enough to avoid the tube feeding.

Her mother was in court and was highly supportive of the orders sought, he added.

The treating consultant told the court that a nasal tube would allow her food intake to be controlled and predictable, but this had so far been resisted by the woman.

‘She has a blind spot regarding how critical she is and the steps needed to save her life,’ he said.

The patient’s psychiatrist said: ‘Objectively, she understands that she has an illness, but she is incapable of appreciating the significant risks it poses to her life.

‘She is very clear that she does not wish to die and she does not believe she will die. She does not believe she requires nasal gastric feeding. She is very clear that she wants to do this by herself without nasal gastric feeding.’

But he said: ‘But our view is that without it she will die.’

The court heard that the hospital may need to start tube-feeding the woman over the course of the weekend if she is unable to take sufficient food and supplements herself.

Mr Justice Robert Haughton said it was clear the woman’s condition was very critical and he said he would grant the orders sought, allowing the tube feeding if necessary.

He noted an application would be made in just over a week by the HSE for the woman to be made a ward of court.

Finally, the judge extended his sympathies to the woman herself and said he hoped the court orders would not have to be implemented.

‘She does not wish to die’