By Ann O'Loughlin

A High Court judge has said he can do no more for a youth who turns 18 next year and is refusing to undergo treatment for an advanced cancer condition.

Despite many explanations from medical and other professionals, the youth maintains there is nothing wrong with him and he does not have cancer, the court was told.

The President of the High Court, Mr Justice Peter Kelly, said he was not prepared to make orders, as urged by the youth's mother, for the detention and compulsory treatment of her son in a secure unit.

There is no secure unit in the country where cancer treatment is provided and he would not make orders turning a hospital oncology unit into a "quasi-prison", with gardaí present, to the detriment of other patients.

It is not often one hears words of praise for the HSE but, as far as this case is concerned, the care, attention and concern shown by all involved in his treatment, and the lawyers, is "second to none", he added.

If the treatment was availed of, there was a good prospect of it curing his condition, he also noted.

Because of the youth being a minor and his failure to engage with treatment, particularly chemotherapy, the HSE applied earlier this year to have him made a ward of court with a view to facilitating his treatment.

When the case returned before Mr Justice Kelly today, he was told by Stephen Brady BL, for the HSE, the youth has failed to attend several chemotherapy appointments. Although he attended an appointment earlier this month, he refused to undergo chemotherpay and spoke to the doctors where he appeared not to fully understand the diagnosis and on occasions laughed inappropriately.

He was told there was a danger of relapse if the treatment was broken up, counsel said.

It seemed nothing more could be done, counsel said. There was "a degree of vulnerability" in the youth's situation and concerns had been expressed by social workers and medics, he added.

Natalie McDonnell, for the general solicitor for wards of court, said they had difficulties making contact with him and had a number of concerns, including he had threatened to sue the HSE, alleging he had been misdiagnosed with cancer. There were also concerns about his drug use and other issues. It was all "regrettable and difficult but he is approaching 18", she said.

Tim O'Leary, for the youth's mother, said the situation was a "tragedy" with a difficult family background. The mother was concerned to do her best for him and wanted him removed from home and detained in a secure unit and treated for cancer.

While she was advised it was very difficult for the court to make such orders, she was "at her wits end".

In his ruling, Mr Justice Kelly said the youth appeared to have "almost a death wish" but he is in his 18th year and it had been fully explained to him many times why the treatment was necessary.

He appreciated the family situation was "not good" but he could not do as the mother sought. He would not turn an oncology department or unit into a prison when there was already "huge expenditure of time and effort" by busy medical professionals and social workers "and he just will not cooperate".

Because there was no order he could usefully make, he would discharge the wardship protection.

All involved had done their best and no more could be done if the youth was not willing to voluntarily undergo the treatment, he said.