M.X. v Health Service Executive

• Jurisdiction: Ireland
• Judge: Mr. Justice John MacMenamin
• Judgment Date: 23 November 2012
• Neutral Citation: [2012] IEHC 491
• Court: High Court
• Docket Number: [2011 No. 9548 P]
• Date: 23 November 2012

[2012] IEHC 491

THE HIGH COURT

[No. 9548P/2011]

X (M) [Apum] v Health Service Executive & Ors

BETWEEN

M.X. [APUM]

PLAINTIFF

AND

HEALTH SERVICE EXECUTIVE

DEFENDANT

AND

BY ORDER THE ATTORNEY GENERAL

NOTICE PARTY

AND

IRISH HUMAN RIGHTS COMMISSION

AMICUS CURIAE

HEALTH SERVICE EXECUTIVE v X (M) UNREP MACMENAMIN 29.7.2011 2011/25/6515 2011 IEHC 326

MENTAL HEALTH ACT 2001 S57

WOODS, STATE v AG & KELLY 1969 IR 385

MURPHY v ROCHE & ORS 1987 IR 106 1986/7/1349

CARMODY v MIN FOR JUSTICE & ORS 2010 1 IR 635 2010 1 ILRM 157 2009/8/1838 2009 IESC 71

MENTAL HEALTH ACT 2001 S60

CONSTITUTION ART 40.3

EUROPEAN CONVENTION ON HUMAN RIGHTS & FUNDAMENTAL FREEDOMS ART 5

MENTAL HEALTH ACT 2001 S2

MENTAL HEALTH ACT 2001 S4

MENTAL HEALTH ACT 2001 PART IV

MENTAL HEALTH ACT 2001 S56

MENTAL HEALTH ACT 2001 S58

MENTAL HEALTH ACT 2001 S59

MENTAL HEALTH ACT 2001 S57(1)

UN CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES ART 12(1)

UN CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES ART 12(2)

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 300(7)

R & v HAEGEMAN SPRL v BELGIUM 1975 1 CMLR 515 1974 ECR 449

DEMIREL v STADT SCHWABISCH GMUND 1989 1 CMLR 421 1987 ECR 3719

UN CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES ART 12

EEC DIR 2000/43

EEC DIR 2000/78

EEC DIR 2002/73

EEC DIR 97/80

TREATY ON EUROPEAN UNION ART 4(3)

CMSN v FRANCE 2004 ECR I-9328

CONVENTION FOR THE PROTECTION OF THE MEDITERRANEAN SEA AGAINST POLLUTION 16.2.1976 (BARCELONA CONVENTION) ART 4(1)

CONVENTION FOR THE PROTECTION OF THE MEDITERRANEAN SEA AGAINST POLLUTION 16.2.1976 (BARCELONA CONVENTION) ART 8

UN CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES ART 44(1)

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 13

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 26

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 47(2)

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 55

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 71(1)

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 80(2)

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 89

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 93

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 95

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 285

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 300(2)

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 300(3)

CMSN v COUNCIL 2006 ENV LR 45 2006 ECR I-1

CMSN v EUROPEAN PARLIAMENT 2006 ENV LR 46 2006 ECR I-107

LESOOCHRANARSKE ZOSKUPENIE VLK v MINISTERSTVO ZIVOTNEHO PROSTREDIA SLOVENSKEJ REPUBLIKY 2012 QB 606 2012 3 WLR 278 2012 AER (EC) 1 2011 2 CMLR 43 2011 ENV LR 28

UNECE CONVENTION ON ACCESS TO INFORMATION PUBLIC PARTICIPATION IN DECISION-MAKING & ACCESS TO JUSTICE IN ENVIRONMENTAL MATTERS ( AARHUS CONVENTION) 25.6.1998 ART 9(3)

TREATY ESTABLISHING THE EUROPEAN COMMUNITY ART 174

R (M (N)) v ISLINGTON LONDON BOROUGH COUNCIL 2012 2 AER 1245 2012 PTSR 1582 2012 EWHC 414 (ADMIN)

FITZPATRICK & RYAN v K (F) & AG 2009 2 IR 7 2008/24/5254 2008 IEHC 104

A WARD OF COURT (WITHHOLDING MEDICAL TREATMENT) (NO 2), IN RE 1996 2 IR 79

CONSTITUTION ART 40.1

T (R) v DIRECTOR OF THE CENTRAL MENTAL HOSPITAL 1995 2 IR 65 1995 2 ILRM 354 1995/5/1664

HEALY, STATE v DONOGHUE & ORS 1976 IR 325

EUROPEAN CONVENTION ON HUMAN RIGHTS & FUNDAMENTAL FREEDOMS ART 6

O'LEARY v AG 1993 1 IR 102 1991 ILRM 454 1990/10/2890

EUROPEAN CONVENTION ON HUMAN RIGHTS & FUNDAMENTAL FREEDOMS ART 6(2)

UN UNIVERSAL DECLARATION OF HUMAN RIGHTS 10.12.1948 ART 11

AMERICAN CONVENTION ON HUMAN RIGHTS 22.11.1969 ART 8(2)

AFRICAN [BANJUL] CHARTER ON HUMAN & PEOPLES RIGHTS 27.6.1981 ART 7

H (E) v CLINICAL DIRECTOR OF ST VINCENTS HOSPITAL (FREYNE) & MENTAL HEALTH TRIBUNAL 2009 3 IR 774 2009 2 ILRM 149 2009/24/5948 2009 IESC 46

GOODEN v ST OTTERANS HOSPITAL 2005 3 IR 617 2001/11/2896

CONSTITUTION ART 40.3.1

EUROPEAN CONVENTION ON HUMAN RIGHTS ACT 2003 S2

EUROPEAN CONVENTION ON HUMAN RIGHTS ACT 2003 S3

EUROPEAN CONVENTION ON HUMAN RIGHTS ACT 2003 S4

EUROPEAN CONVENTION ON HUMAN RIGHTS ACT 2003 S5

MCD (J) v L (P) & M (B) 2010 2 IR 199

SHTUKATUROV v RUSSIA 2012 54 EHRR 27 2008 MHLR 238

GLOR v SWITZERLAND UNREP ECHR 30.4.2009 (APPLICATION NO 13444/04)

KISS v HUNGARY 2013 56 EHRR 38 2010 MHLR 245 2010 ECHR 692

X v FINLAND UNREP 3.7.2012 2012 ECHR 1371 (APPLICATION NO 34806/04)

EUROPEAN CONVENTION ON HUMAN RIGHTS & FUNDAMENTAL FREEDOMS ART 8

EUROPEAN CONVENTION ON HUMAN RIGHTS & FUNDAMENTAL FREEDOMS ART 13

RYAN v AG 1965 IR 294

CONSTITUTION ART 38.1

EAST DONEGAL CO-OPERATIVE LIVESTOCK MART LTD & ORS v AG 1970 IR 317

STORCK v GERMANY 2006 43 EHRR 6 2005 MHLR 211

WINTERWERP v NETHERLANDS 1979-80 2 EHRR 387

EUROPEAN CONVENTION ON HUMAN RIGHTS & FUNDAMENTAL FREEDOMS ART 5(4)

STANEV v BULGARIA 2012 55 EHRR 22 2012 MHLR 23

EUROPEAN CONVENTION ON HUMAN RIGHTS & FUNDAMENTAL FREEDOMS ART 6(1)

R (WILKINSON) v BROADMOOR HOSPITAL 2002 1 WLR 419 2001 MHLR 224 2002 ACD 47

MENTAL HEALTH ACT 1983 S58(3) (UK)

MENTAL HEALTH ACT 1983 S63 (UK)

CAHILL v SUTTON 1980 IR 269

CONSTITUTIONAL LAW

Personal rights

Right to self-determination - Right to bodily integrity - Right to privacy - Right to autonomy - Right to dignity - Right to equality - Right of access to courts - Mental health - Involuntary patient - Treatment - Capacity to consent - Assisted decision making - Whether Mental Health Act 2001, s 60 unconstitutional - Whether Mental Health Act 2001, s 6- incompatible with European Convention on Human Rights - Whether United Nations Convention on the Rights of Persons with Disabilities directly enforceable - Whether plaintiff entitled to on-going mandatory court review - Practice and procedure - Locus standi - Provisions directed to group of persons - Whether plaintiff having locus standi - Cahill v Sutton [1980] IR 269; Carmody v Minister for Justice [2009] IESC 71, [2010] 1 IR 635; Commission of the European Communities v Council of the European Union (Case C-94/03) [2006] ECR I-00001; Commission of the European Communities v European Parliament and Council of the European Union (Case C-178/03) [2006] ECR I-00107; Commission of the European Communities v French Republic (Case C-239/03) [2004] ECR I-09325; Demirel v Stadt Schwabisch Gmund (Case 12/86) [1987] ECR 3719; East Donegal Co-Operative Livestock Mart Ltd v Attorney General [1970] IR 317; EH v Clinical Director of St Vincent's Hospital [2009] IESC 46, [2009] 3 IR 774; Fitzpatrick v FK [2008] IEHC 104, [2009] 2 IR 7; Glor v Switzerland (App No 13444/04) (Unrep, ECHR, 30/4/2009); Gooden v St Otteran's Hospital (2001) [2005] 3 IR 617; Gorshkov v Ukraine (App No 67531/01) (Unrep, ECHR, 8/11/2005); Haegeman v Belgian State (Case 181/73) [1974] ECR 449; Health Service Executive v MX [2011] IEHC 326, [2012] 1 IR 81; Herczegfalvy v Austria (App No 10533/83), (1992) 15 EHRR 437; In re a Ward of Court (withholding medical treatment) (No 2) [1996] 2 IR 79; In re Philip Clarke [1950] IR 235; J McD v PL [2009] IESC 81; [2010] 2 IR 199; Kiss v Hungary (App No 38832/06) (Unrep, ECHR, 20/5/2010); Lesoochranárske zoskupenie VLK v Ministerstvo zivotného prostredia Slovenskej republiky (Case C-240/09) [2011] ECR I-01255; Murphy v Roche [1987] IR 106; Narinen v Finland (App No 45027/98) (Unrep, ECHR, 1/6/2004); O'Leary v Attorney General [1993] 1 IR 102; Rakevich v Russia (App No 58973/00) (Unrep, ECHR, 28/10/2003); R (on the application of NM) v Islington London Borough Council [2012] EWHC 414 (Admin), [2012] 2 All ER 1245; RT v Director of Central Mental Hospital [1995] 2 IR 65; R (Wilkinson) v Broadmoor Special Hospital Authority [2001] EWCA Civ 1545, [2002] 1 WLR 419; Ryan v Attorney General [1965] IR 294; Shtukaturov v Russia (App No 44009/05), (2012) 54 EHRR 27; Stanev v Bulgaria (App No 36760/06), (2012) 55 EHRR 22; The State (Healy) v Donoghue [1976] IR 325; The State (Woods) v Attorney General [1969] IR 385; Storck v Germany (App No 61603/00), (2005) 43 EHRR 96; Wilkinson v United Kingdom (App No 14659/02) (Unrep, ECHR, 28/2/2006); Winterwerp v Netherlands (App No 6301/73) (1979) 2 EHRR 387 and X v Finland (App No 34806/04) (Unrep, ECHR, 3/7/2012) considered - Mental Health Act 2001 (No 25), ss 2, 4, 56, 57 and 60 - European Convention on Human Rights Act 2003 (No 20), s 5 - Constitution of Ireland 1937, Art 40 - European Convention for the Protection of Human Rights and Fundamental Freedoms - United Nations Convention on the Rights of Persons with Disabilities, art 12 - Relief refused (2011/9548P - McMenamin J - 23/11/2012) [2012] IEHC 491

X(M) v Health Service Executive

Facts: The Court had already given judgment in the proceedings in HSE V. X [APUM] [2011] IEHC 326. The plaintiff was treated pursuant to s 57 Mental Health Act 2001 and sought to challenge a number of aspects of her care. It was claimed that medical decisions had been made in a context of her incapacity by reason of treatment resistant paranoid schizophrenia that had failed to have regard to her rights and that she had inter alia an entitlement to have the decision as to her treatment to be subject to an independent review. It was alleged that she was entitled to have her treatment considered in light of her wishes. The plaintiff was receiving regular administrations' of drugs. The Court considered whether a treatment decision made pursuant to s. 60 of the Act of 2001 necessitated on-going court review on a mandatory basis and whether it was constitutionally compatible. The Court also considered whether she was entitled to a declaration of incompatibility with s. 5 European Convention on Human Rights Act 2003. The issue arose as to whether the plaintiff had locus standi.

Held by MacMenamin J. that the plaintiff did not have the capacity to make decisions. It fell to the Court to make decisions on her treatment. The patient wished to make a decision which would be not only detrimental to her...