The High Court has granted orders permitting the withdrawal of life-sustaining treatment and the cessation of active supportive care for a woman who suffered catastrophic hypoxic brain injury following cardiac arrest.
The case concerned SM, a 51-year-old woman with a mild intellectual disability and an emotionally unstable personality disorder, who had been a ward of court since February 2023. After developing respiratory difficulties, she was admitted to hospital in early November 2025 and later discharged. On 25 November 2025, she suffered a prolonged cardiac arrest at her placement, received extensive CPR and was transferred to hospital, where she experienced a further cardiac arrest. She subsequently became deeply comatose and unresponsive, with a severe brain injury.
The HSE applied to the High Court seeking permission to withdraw life-sustaining treatment, including mechanical ventilation, artificial nutrition and cardiovascular supports, and to transition SM to palliative care. The medical evidence was unanimous that her condition was permanent, that she would never regain consciousness and that no intervention could lead to recovery or meaningful improvement.
Delivering judgment, Mr Justice David Barniville emphasised that the court was required to consider all of SM’s constitutional rights, including her right to dignity. He accepted the evidence that continued invasive interventions would provide no benefit, would merely prolong the dying process and would risk further harm, including infection and additional cardiac events. The Court had regard to the Medical Council’s ethical guidance, which discourages the continuation of treatment that is unlikely to work or where the burdens outweigh any benefit.
The judge stressed that SM’s rights were not diminished by her status as a ward of court, but that in the absence of capacity, it fell to the court to determine her best interests within constitutional limits. He was satisfied that the application was appropriate, that the medical opinions were consistent and corroborated, and that a move to palliative care would ensure comfort and dignity without reducing the quality of care.
Relying in particular on established authority concerning the withholding of medical treatment, the High Court concluded that it was in SM’s best interests to permit the withdrawal of life-sustaining measures and the cessation of active supportive care. Orders were made accordingly.
The court noted that following the delivery of judgment, SM had passed away, and Mr Justice Barniville expressed his condolences to her family, carers and loved ones.Top of Form
Click here to read the full judgment.
The High Court has granted orders permitting the withdrawal of life-sustaining treatment and the cessation of active supportive care for a woman who suffered catastrophic hypoxic brain injury following cardiac arrest.
The case concerned SM, a 51-year-old woman with a mild intellectual disability and an emotionally unstable personality disorder, who had been a ward of court since February 2023. After developing respiratory difficulties, she was admitted to hospital in early November 2025 and later discharged. On 25 November 2025, she suffered a prolonged cardiac arrest at her placement, received extensive CPR and was transferred to hospital, where she experienced a further cardiac arrest. She subsequently became deeply comatose and unresponsive, with a severe brain injury.
The HSE applied to the High Court seeking permission to withdraw life-sustaining treatment, including mechanical ventilation, artificial nutrition and cardiovascular supports, and to transition SM to palliative care. The medical evidence was unanimous that her condition was permanent, that she would never regain consciousness and that no intervention could lead to recovery or meaningful improvement.
Delivering judgment, Mr Justice David Barniville emphasised that the court was required to consider all of SM’s constitutional rights, including her right to dignity. He accepted the evidence that continued invasive interventions would provide no benefit, would merely prolong the dying process and would risk further harm, including infection and additional cardiac events. The Court had regard to the Medical Council’s ethical guidance, which discourages the continuation of treatment that is unlikely to work or where the burdens outweigh any benefit.
The judge stressed that SM’s rights were not diminished by her status as a ward of court, but that in the absence of capacity, it fell to the court to determine her best interests within constitutional limits. He was satisfied that the application was appropriate, that the medical opinions were consistent and corroborated, and that a move to palliative care would ensure comfort and dignity without reducing the quality of care.
Relying in particular on established authority concerning the withholding of medical treatment, the High Court concluded that it was in SM’s best interests to permit the withdrawal of life-sustaining measures and the cessation of active supportive care. Orders were made accordingly.
The court noted that following the delivery of judgment, SM had passed away, and Mr Justice Barniville expressed his condolences to her family, carers and loved ones.
Click here to read the full judgment.