Refusal of medical treatment by a prisoner

A first instance decision from Ireland, AB v CD [2016] IEHC 541 is unusual for its consideration of refusal of medical treatment by a prisoner serving a life sentence for murder.

The discussion of the initial provision of treatment, given concerns about capacity and in the circumstances of an emergency, is not controversial. However far more novel is the discussion of whether a prisoner has a right to autonomy to refuse medical treatment: [13] ff. The court decided against the existence of such autonomy at [50], saying that  it was a false premise that a prisoner has a legal entitlement to exercise his or her autonomy in a manner which would frustrate the order of the court remanding or sentencing him or her.

The court concluded at [52]:

Thus, I made an order compelling the defendant to undergo treatment, on the basis that as a prisoner in custody under a court order, he is not simply entitled to refuse treatment where this would either directly or ultimately put his life at risk and thereby frustrate the verdict and order of the court. To that extent, his rights to autonomy, privacy and bodily integrity are qualified by his status as a prisoner and his liability to undergo his sentence, which necessarily involves a prohibition on his frustration of that sentence by self-harm including harm by neglect or omission in relation to matters such as medical or surgical treatment, nutrition or hydration.


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