A senior doctor pleaded with a woman with myalgic encephalomyelitis (ME) to stay in hospital months before she died, an inquest heard.
Maeve Boothby-O’Neill, 27, had suffered from the condition since the age of 13 and was treated at the Royal Devon and Exeter Hospital before dying at her home in October 2021.
An inquest in Exeter found that Miss Boothby-O’Neill had been admitted to hospital three times that year for treatment for malnutrition.
The hearing focuses on the final months of Miss Boothby-O’Neill’s life, during which time she was confined to bed, unable to chew food and had difficulty drinking because she could not sit up.
“Very difficult situation”
During her second admission, between May and June, Dr Kashyap Patel, a consultant in diabetes and endocrinology, said he tried to persuade her to stay on the ward despite her request to be discharged.
Dr Patel told the hearing the situation was “difficult” and he “did not expect” Miss Boothby-O’Neill’s request, but as she had mental capacity he could not stop her from leaving.
He said: “I was prepared to keep her as long as necessary.
“I had no intention of sending her home because we were in a very difficult situation.
“Later, an experienced occupational therapist made it clear to me that she needed 24-hour care.”
‘Please stay’
The inquest heard that Miss Boothby-O’Neill had told doctors she wanted to be discharged and continue her treatment at home in Exeter.
Dr Patel said he had spoken to Miss Boothby-O’Neill’s mother, Sarah Boothby, and sought advice from other doctors, social workers and occupational therapists.
“I said to her, ‘Please stay.’ I found that very hard, but I also understood her point of view that the hospital was not the right place for her,” he said.
“I’m a very persuasive consultant. I tried talking to Sarah too.
“I understood both sides and had a very frank conversation with Sarah that she couldn’t handle.”
Dr Patel told the inquest he had “talked about protection” and offered the family a break which “Maeve didn’t like”.
During this period, Miss Boothby-O’Neill was fed by syringe in her mouth and hospital records show a “slow and steady improvement” in her daily calorie intake.
“Seemingly irrational choices”
“She expressed her wish to be sent home as soon as possible, regardless of whether the long-term care program was in place,” he told the inquest.
“Maeve also said she was happy with the care her mother provided and felt safe returning home. She understood that her mother was under significant pressure and wanted her to have long-term support.”
Dr Patel told the inquest the “only reasonable option” in the short term to respect Miss Boothby-O’Neill’s wishes was “to discharge her with the emergency care team and additional support from her mother”.
Asked if he could have done more for Miss Boothby-O’Neill, Dr Patel said: “I found it very hard and difficult, and it often is the case for any health professional when someone makes seemingly irrational choices.”
He added: “If I had known the future, I might have tried my extreme powers of persuasion, but I did not know the future.
“If I had known that, I would definitely have tried.”
