It has just occurred to me that today is Holy Thursday. I spent the last few days reading about a young man who died on Holy Thursday. His name was John Carthy and he was 27 years old. Coincidentally, Holy Thursday was a significant day in John Carthy’s life as his father and grandfather also died on this day.
John Carthy was a young man who lived with his mother Rose at their home in Abbeylara, Co Longford. The Council had built a new house for the Carthy family nearby and they were awaiting a power connection before the move. John, who was diagnosed with depression (and medicated accordingly) since 1992, did not really want to move from the old house. According to his mother, on 19th April 2000 he became ‘somewhat agitated’. He went outside and discharged some shots from his legally held weapon. He re-entered the house and told his mother to ‘go to her sister up the road for a visit’. She left for her sisters house and fearing for her son’s welfare, rang the gardaí shortly afterwards. A two day siege followed, which ended with John being shot dead by members of An Garda Síochána (Irish Police) on Holy Thursday, 20th April 2000. What followed was an unprecedented public outcry for this affable young man and repercussions which still reverberate in Irish law today. It’s just a shame that John didn’t survive to witness it.
After John Carthy’s death, the Oireachtas appointed a Special Committee to conduct an inquiry (the Abbeylara inquiry) into the circumstances surrounding his fatal shooting. The gardaí whose actions were under investigation challenged the constitutionality of the Committee’s inquiry. In Maguire v Ardagh the Supreme Court found that the Oireachtas acted ultra vires (outside of its authority) when it set up the inquiry into the fatal shooting of John Carthy. Subsequently in 2011 the Irish people were asked to decide by referendum whether to give the houses of the Oireachtas (the Dáil and Seanad) express power to conduct inquiries into matters of general public importance and, in doing so, to make findings of fact about any person’s conduct. The literature’s headline was ‘The Abbeylara Case’ and the people voted No. Details here.
In 2002 a tribunal was set up (The Barr Tribunal) to investigate the facts and circumstances surrounding this young man’s death. The investigation was to last four years and cost the state over €18 million. The report laid most of the blame firmly at the door of the gardaí, finding critical errors and negligence by An gardaí Síochána during the 25-hour siege. The Barr Tribunal report here.
Considering the tribunal went on for so long, had numerous witnesses, at huge cost to the state, why was John Carthy’s medical treatment largely overlooked? From the age of 18/19 when he first entered college, a year after his father died, he attended his doctor and was medicated for depression, then bipolar. Understandable depression it has to be said, following these life changing events. Why was the adverse effects of these drugs not investigated? He was certainly prescribed enough of them and had seen enough medical professionals in his last few years. In the rush to blame the gardaí, was John’s death fully investigated? Was his ‘care’ by the medical professionals partly responsible? Sure he was fatally shot by gardaí but would he have been in this dangerous and volatile situation without the intervention of mind-altering drugs? His doctor described a manic episode some weeks before his death, despite having lithium levels above the therapeutic range, which is supposed to prevent bouts of mania.
According to the inquiry, John Carthy first became unwell at Christmas time 1991. The inquiry mentions that his father, a Bord na Mona employee also named John Carthy, died in 1990, the previous year. In early 1992 he attended his doctor and was medicated for depression. He was subsequently diagnosed (2005) with bipolar affective disorder. Over the years he was treated with medication which included Lithium, Gamanil, surmontil, prothiaden, Xanax, Stelazine and melleril.
Excerpt from the Barr Tribunal Report:
“John Carthy attended the local national school at Abbeylara. Thereafter, he went to technical/secondary school in Granard, County Longford. He completed his Leaving Certificate examination at Granard Convent in 1991. Having obtained his Leaving Certificate, he attended agricultural college at Warrenstown, County Meath in September, 1991. Mrs. Rose Carthy gave evidence that her son was in good health up to the time he went to Warrenstown. While there he began to have symptoms of depression.”
Timeline of drugs that John Carthy was prescribed:
Early 1992 Treated for depression. Prescribed gamanil and xanax
July 1992 John Carthy stopped his medication for almost a year, with no reprecussions.
June 1993 John, following an accident at work attended Dr Cullen who recommended an appointment with a psychiatrist. He was prescribed lentizol, an antidepressant.
July 1993 Presented in a tearful and ‘very distressed state’ complaining of back pain. Admitted to St. Loman’s hospital.
August 1993 Prescribed gamanil and melleril.
August 1993 Stopped his medication for four to five days, complained of feeling ‘withdrawn’. Described as being depressed, tearful and agitated and was re-admitted until 31 August.
September 1993 Melleril was discontinued and prescribed stelazine.
January 1995 Again re-admitted to St. Loman’s hospital with paranoid ideation.
February 1995 Discharged. His medication at this time was reported as stelazine, surmontil and cogentin.
April 1995 John Carthy was concerned about his lack of progress. Referred to another doctor who found he was not suffering from depression.
May 1995 Diagnosed with manic depression or bipolar affective disorder. Prescribed surmontil and stelazine.
Between May-July 1995 Prescribed Lithium.
June 1995 Stelazine and camcolit were prescribed.
May 1997 Following a car accident, Sleeping tablets were also prescribed.
November 1997 Stelazine was reduced. Prescribed stelazine and lithium.
November 1998 Lithium increased from 750mgs to 1,000mgs (and stelazine).
March 1999 Prescribed surmontil, an antidepressant.
April 1999 Medication changed to a ‘less sedating’ antidepressant, prothiaden
May 1999 Blood tests found lithium to be above the therapeutic range. His treatment was not changed.
September 1999 John’s mother Mrs. Rose Carthy collected his prescription for lithium, prothiaden and stelazine.
January, 2000 John’s mother Mrs. Rose Carthy again collected prescription for lithium, prothiaden and stelazine.
February 2000 John had ‘high’ episode. Was advised by doctor, over the phone, to increase his stelazine. Prothiaden stopped.
February 2000 Doctor had no recollection of giving advice over the phone but stated that ‘‘standard advice would be immediately cold turkey, stop your antidepressant’’.
February 2000 Doctor thought that John was elated, restless and agitated but it did not raise any concern in his mind as there was nothing out of the ordinary to alarm him. Stelazine increased.
March, 2000 Prescription for stelazine and camcolit, with the dosage of stelazine increased from one tablet a day to two tablets a day; earlier prescriptions had contained four items (stelazine and camcolit, melzine and prothiaden).
March 2000 Doctor describes ‘an episode of mania’. Categorised the condition as severe.
March 2000 Reduced the dosage of stelazine.
18th April 2000 John collected medication in respect of a prescription that had been written in January for lithium, stelazine and prothiaden.
20th April 2000 (Holy Thursday) John was fatally shot.
Barr Tribunal Report: