Urgent application by the treating Trust to permit treatment in respect a 16-year old girl, B, refusing treatment i.e. insulin, with the result her life was threatened by diabetic ketoacidosis [‘DKA’]. Application allowed.
The case concerned a 16-year old child, who normally lived with her grandfather, had a 'difficult' relationship with her mother (B had refused to allow the Trust to contact M) and no relationship with her father. B was admitted to hospital, with her own agreement, the day before the hearing, following her refusal to take insulin in respect of her condition - insulin dependent diabetes mellitus. Upon admission, she also agreed to blood tests and insertion of an intravenous cannula for rehydration.
Tests showed markedly elevated blood sugars and ketones; in the face of these, B continued to refuse insulin. Upon rehydration, B appeared confused and vomited due to her having developed DKA, resulting in admission to the High Dependency Unit. The treating team opined that aggressive short-term treatment to control/reverse the DKA was required, to avoid serious sequelae, including death. Treatment of DKA was described as "meticulously standardised" and 'there [wa]s "universal consensus" in the paediatric community about the interventions that are required.'
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