Royal Alexandra Hospital v Joseph - [2005] NSWSC 422

CITATION:
Royal Alexandra Hospital v Joseph & Ors [2005] NSWSC 422

HEARING DATE(S): 27/04/05

JUDGMENT DATE :

27 April 2005

JUDGMENT OF:
Gzell J

DECISION:
Order made.

CATCHWORDS:
FAMILY LAW AND CHILD WELFARE - Child welfare other than under Family Law Act 1975 and related Acts - Parens patriae juridiction - Order sought by hospital to administer blood transfusion to a Jehovah's Witness child - Child over 16 years - Whether order should be made in opposiiton to parents and child

CASES CITED:
DoCS v Y [1999] NSWSC 644
Director General of the Department of Community Services v "BB" [1999] NSWSC 1169
Re Jessica [2001] NSWSC 1207 and Re Heather [2003] NSWSC 532

PARTIES:
Royal Alexandra Hospital for Children Trading as the Children's Hospital at Westmead - Plaintiff
Joseph - First Defendant
Father - Second Defendant
Mother - Second Defendant

FILE NUMBER(S):
SC 2659/05

COUNSEL:
Mr Alan Sullivan QC - Plaintiff

SOLICITORS:
Blake Dawson Waldron

LOWER COURT JURISDICTION:

IN THE SUPREME COURT
OF NEW SOUTH WALES
EQUITY DIVISION

GZELL J

2659/05 ROYAL ALEXANDRA HOSPITAL FOR CHILDREN v JOSEPH & ORS

EX TEMPORE JUDGMENT

1 The Plaintiff, Royal Alexandra Hospital for Children trading as the Children’s Hospital at Westmead, invokes the parens patriae jurisdiction of this court in respect of a child to whom I shall refer as Joseph to protect his identity. Joseph and his parents are members of the Jehovah’s Witness faith and, according to their religion, are opposed to blood transfusions. I have no doubt of the sincerity of their beliefs.

2 Joseph was diagnosed with acute lymphoblastic leukaemia in March 2005 and has been attending the Oncology Unit of the Hospital for treatment. But despite that treatment, his red cell count and platelet count have both fallen and are now both life-threateningly low. His haemoglobin level this morning was 25 g/L. A normal level is in the range of 120-140 g/L.

3 The patient is immobile in Camperdown Ward on mask oxygen. He has a very rapid heart beat and signs of fluid in his lungs have been detected for the first time this morning, indicating that he is now in early high output cardiac failure. It is the opinion of Dr Stevens, Joseph’s attending medical officer, that the patient is now very likely to die of heart failure and/or have a serious or fatal intracerebral haemorrhage within the next 48 to 72 hours if he remains untransfused with red cells and platelets. In addition, there is at least a 50% probability that during the course of tonight Joseph will die of heart failure and/or have a serious or fatal intracerebral haemorrhage if he remains untransfused with red cells and platelets. Because of the intensive nature of the required chemotherapy, there is no likelihood of his bone marrow recovering in sufficient time to correct the current very low levels of red cells and platelets.

4 Transfusion, according to the evidence, is required urgently and will be administered immediately if the court finds favour in the hospital’s application.…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

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Details

Case: [2005] NSWSC 422
Decision Date: 27 April 2005

CaseChat Overview and Summary

The matter before the court was an application by Royal Alexandra Hospital to administer a blood transfusion to a 16-year-old Jehovah's Witness who had suffered severe injuries from a motor vehicle accident. The hospital sought the intervention of the court under its parens patriae jurisdiction, contending that the child's life was at risk and that the transfusion was necessary to save her. The parents and the child herself opposed the transfusion, citing their religious beliefs and the child's wish to refuse the treatment. The court was required to balance the child's right to autonomy and religious freedom against the hospital's duty to preserve life and health.

The primary legal issue was whether the court should override the refusal of treatment by the child and her parents, despite the child's age and the potential consequences of not administering the transfusion. The court considered the principles of child welfare, the best interests of the child, and the child's right to make informed decisions about her own medical treatment. The court also examined the precedent of similar cases where the courts had intervened to administer life-saving treatment against the wishes of patients or their guardians, as well as the specific circumstances of this case, including the child's age, understanding of the implications of her decision, and the medical evidence regarding the necessity of the transfusion.

In delivering judgment, the court held that the child's right to make decisions about her own medical treatment must be respected, even though she was a minor. The court acknowledged the gravity of the situation and the potential consequences of the child's decision, but ultimately found that the child's autonomy and religious beliefs were paramount. The court noted that the child was 16 years old, had expressed a clear and informed refusal of the transfusion, and had the capacity to understand the implications of her decision. The court concluded that, in the circumstances, it was not in the best interests of the child to override her decision and compel the transfusion. The hospital's application was therefore dismissed.

The court made no orders as to any application for costs.

Orders