Court Approves "Ceiling of Care" that Excludes "Coercive Feeding"

The Irish Health Service Executive recently obtained a High Court declaration that they can refrain from "coercive feeding" for P.J., an incapacitated seventy-eight-year-old man. 

This is not a case about withholding life-sustaining treatment. Rather, clinicians want to refrain from instituting "invasive and coercive interventions which they regard, in good faith and in accordance with professional ethics, as futile, harmful, and disproportionate." Still, this will likely result in P.J.'s "premature death."   

While P.J. lacks capacity, the court looked to a prior document recording P.J.'s wishes. While that document is not a valid advance directive, it remains a "clear statement of the [his] will and preference."

The court ruled that it is lawful for P.J.'s treating clinicians to apply a "ceiling of care" that excludes "coercive feeding, coercive medical treatment, and cardiopulmonary resuscitation." 

Judge Emily Egan