Medical decisions for Ms D
Ms D* is a woman in her mid-forties with a severe intellectual disability who lives in shared supported accommodation. She also has epilepsy characterised by frequent seizures.
Ms D had regular admissions to hospital because of swallowing difficulties. The treating team at the hospital could not attribute this difficulty in swallowing to a medical condition, believing that the problem was behavioural.
The treating team proposed the insertion of a feeding tube into Ms D’s stomach to ensure consistent medication intake, thereby reducing seizure activity. The tube could also supplement nutritional intake when necessary.
As Ms D was unable to consent to the procedure and there was no person responsible to consent on her behalf, the hospital submitted a Section 42K notice to OPA. This notice allows the medical practitioner to carry out the treatment without any consent being given, as long as they believe it is in the best interests of the patient and they submit a notice to OPA that complies with the requirements set out in the Guardianship and Administration Act.
The OPA advisor responsible for registering the Section 42K notice contacted staff at the hospital and the SSA to discuss the proposed procedure. During these discussions, staff at the SSA revealed misgivings about the procedure; they felt that Ms D was able to ingest her medication most of the time, and questioned the management of Ms D’s food and medication intake during acute admissions.
As there was a level of contention as to whether the procedure was in Ms D’s best interests, a more thorough examination of the ramifications of the procedure was warranted and an application to VCAT for guardianship was recommended.
*Names have been changed. Image for illustrative purposes only.