Mental Health, Suicide Risk and Dublin III Transfers: The “Real and Proven Risk” Standard in D.S. v IPAT [2025] IEHC 654

Mental Health, Suicide Risk and Dublin III Transfers: The “Real and Proven Risk” Standard in D.S. v International Protection Appeals Tribunal [2025] IEHC 654

1. Introduction

1.1 Background to the case

The applicant, D.S., is a Zimbabwean national who fled Zimbabwe in December 2022, travelling through South Africa, Israel, Austria and Germany before arriving in Ireland on 14 April 2023, where he applied for international protection. His movements engaged the Dublin III Regulation (Regulation (EU) No. 604/2013), which determines which Member State is responsible for examining an application for international protection. The chronology is central:
  • 10 January 2023 – Austria issued a take charge request to France, accepted by France on 10 February 2023.
  • 3 May 2023 – Austria sought to extend the transfer period to France under Article 29(2) Dublin III; France gave no response.
  • 17 May 2023 – Ireland issued a take back request to Austria; Austria refused, relying on France’s earlier acceptance.
  • 24 May 2023 – Ireland issued a take charge request to France under Article 12(2) or (3); France accepted on 24 July 2023.
  • 27 September 2023 – D.S. was interviewed under Article 5 Dublin III by the International Protection Office (IPO).
  • 16 November 2023 – IPO made a transfer decision to France.
  • 22 November 2023 – D.S. appealed to the International Protection Appeals Tribunal (IPAT).
The applicant suffers from serious physical and mental health problems: he is HIV positive, has latent tuberculosis, and has been homeless. He claims complex PTSD, severe depression and generalised anxiety disorder. A medicolegal report by Dr Joan Giller (obstetrician & gynaecologist / psychotherapist) dated 18 September 2023 (the “first report”) concluded that if he were transferred to France or Austria, or returned to Zimbabwe, he would present a high risk of suicide. On 30 June 2025, the IPAT dismissed his appeal and affirmed the transfer decision. On 1 September 2025, the High Court (O’Regan J.) granted leave for judicial review but refused interim injunctive relief restraining transfer, emphasising the integrity of the Dublin III system (relying on RG v IPAT (No. 1) [2023] IEHC 742). The court, however, expressly allowed for a renewed injunction application if material circumstances changed. In light of State arguments that the September 2023 medicolegal report was “out of date”, the applicant obtained an updated medicolegal report from Dr Giller dated 3 September 2025 (the “update report”), which stated that his mental health had “decompensated even further” and that deportation would expose him to a “serious, rapid and irreversible decline in his mental health” with a “significant risk to his life” due to suicidal ideation. During the substantive judicial review hearing before Bradley J, the Garda National Immigration Bureau (GNIB) issued a letter directing the applicant to attend on 11 December 2025 to facilitate transfer to France. In light of the imminent transfer and the six-month time limit under Dublin III (Article 29), the court treated the case as urgent and the State indicated (without giving a formal undertaking) that no transfer would occur for approximately two weeks pending judgment.

1.2 Issues in dispute

The core legal issues were:
  1. Whether the IPAT’s decision to affirm the Dublin III transfer to France complied with Article 3 ECHR and Article 4 of the EU Charter of Fundamental Rights (“the Charter”), especially in light of:
    • The CK v Slovenia (C‑578/16 PPU) test for transfers involving serious illness and suicide risk; and
    • ECtHR jurisprudence such as Paposhvili v Belgium and MSS v Belgium & Greece.
  2. Whether the IPAT applied the correct “real risk” standard and rigorous assessment approach articulated in Minister for Justice v Rettinger [2010] 3 IR 783.
  3. Whether the IPAT failed to give adequate reasons or took into account irrelevant considerations, particularly regarding:
    • Access to healthcare (including emergency healthcare) during the initial period in France;
    • Reception conditions and material support in France; and
    • The impact of language barriers on a highly vulnerable applicant.
  4. Whether the decision breached constitutional fair procedures (Article 40.3 of the Constitution) and whether the High Court should adopt “curial deference” in reviewing fundamental rights assessments.
  5. The significance of the unchallenged refusal under Article 17(1) Dublin III (the “sovereignty clause”), where the Minister had declined to examine the asylum claim in Ireland on discretionary grounds.

1.3 Outcome

Bradley J refused all reliefs and upheld the IPAT’s decision. He held that:
  • The IPAT had carried out an “individualised assessment” which, in substance, satisfied the requirements of Article 3 ECHR / Article 4 Charter as interpreted by the CJEU in CK and Jawo, even though CK was not expressly cited by the Tribunal.
  • The applicant had not established before the IPAT, on the basis of the first medicolegal report, a “real and proven risk” of inhuman or degrading treatment upon transfer to France, whether due to systemic conditions or his individual vulnerability.
  • The Minister’s transfer procedures and safeguards (including health-data exchange and potential postponement or cancellation of transfers in high-risk cases) were consistent with the obligations under CK, Dublin III and the ECHR.
  • The Article 17(1) discretion refusal remained valid and unchallenged, and thus was not open to review in these proceedings.

2. Summary of the Judgment

2.1 Legal grounds advanced

The applicant’s Statement of Grounds comprised seven main grounds, including:
  1. Ground 1 – CK / Article 3–4 threshold not met: The first medicolegal report was said to meet the Article 3 ECHR / Article 4 Charter threshold as set out in CK (para 98(2)); the State and IPAT allegedly failed to “eliminate serious doubts” as required by CK and Paposhvili.
  2. Ground 2 – Failure to apply Rettinger principles: The IPAT allegedly failed to engage in the rigorous examination of risk required by Rettinger, analogous to European Arrest Warrant cases.
  3. Grounds 3–5 – Inadequate reasoning / irrationality: Alleged failures to:
    • Consider whether emergency healthcare in France would suffice to safeguard fundamental rights;
    • Reconcile apparent acknowledgment of significant reception deficits in France with the conclusion that there is an effective system for material support; and
    • Address the language barrier as a factor exacerbating vulnerability and risk.
  4. Ground 6 – Unfairness and breach of constitutional justice: Alleged unfairness in the decision-making process contrary to Article 40.3.
  5. Ground 7 – Curial deference inappropriate: Argument that the High Court should not defer to the IPAT in a fundamental rights context.

2.2 Court’s principal findings

Bradley J held, in essence, that:
  • The IPAT correctly identified and applied the governing legal standards under Dublin III, the Charter and the ECHR, especially the need to avoid transfers where there is a real risk of inhuman or degrading treatment arising either from:
    • systemic deficiencies (Article 3(2) Dublin III codifying NS & ME), or
    • the applicant’s specific individual vulnerability (CK).
  • The Tribunal undertook an individualised assessment of D.S.’s:
    • physical and mental health (HIV, latent TB, complex PTSD, depression, anxiety, suicidal ideation),
    • medical treatment and medication usage, and
    • engagement (or lack thereof) with psychological and psychiatric services in Ireland.
  • The Tribunal’s reasoning, read as a whole, did not simply ask whether some healthcare was “available” in the abstract; instead, it:
    • considered whether the applicant would be able to access food, shelter and healthcare in France; and
    • assessed whether his transfer would amount to inhuman or degrading treatment, including by reference to his vulnerability.
  • The IPAT’s reliance on up-to-date objective evidence (notably AIDA reports and French legislative reforms) to conclude that:
    • France has functioning systems for vulnerability screening, healthcare and material support,
    • despite imperfections and capacity constraints, the threshold of “extreme material poverty” required by MSS and Jawo was not met,
    was rational and sufficiently reasoned.
  • The Minister’s transfer practices, as evidenced by the affidavit of Mr Bryan Gallagher (including:
    • health-data sharing under Article 32 Dublin III,
    • case conferences with treating clinicians,
    • possible accompaniment by medical staff,
    • postponing or cancelling transfers in very high-risk cases),
    adequately reflected the obligations imposed by CK and Articles 31–32 Dublin III.
  • While judicial review applicants should ordinarily raise specific legal points (e.g. reliance on CK) before the decision-maker, this requirement can yield where fundamental EU rights are in issue; nevertheless, the court found that, even on a substantive analysis, the IPAT’s decision was lawful.
The court therefore refused to quash the IPAT decision and declined to interfere with the intended transfer to France.

3. Analysis

3.1 Legal framework

3.1.1 Charter, ECHR and Dublin III

Bradley J begins by setting out key provisions:
  • Article 1 Charter – Human dignity: “inviolable … must be respected and protected.”
  • Article 4 Charter – Prohibition of torture and inhuman or degrading treatment or punishment: mirrors Article 3 ECHR and is interpreted coextensively via Article 52(3) Charter, though EU law can provide more extensive protection.
  • Article 3 Dublin III:
    • Requires that a single Member State examine any given protection application.
    • Article 3(2) codifies NS & ME: where there are “systemic flaws” in the responsible Member State’s asylum system and reception conditions that create a risk of inhuman or degrading treatment, the determining State must:
      • continue down the hierarchy of criteria to find another responsible State; and
      • if none is available, itself become the responsible State.
  • Article 17(1) Dublin III – “Sovereignty clause”: allows any Member State, by way of derogation from Article 3(1), to decide voluntarily to examine an application lodged with it, even if not responsible under the Dublin criteria. In this case, the Minister refused that request on 2 April 2025; that decision was not challenged and thus remained valid.
  • Articles 27, 29, 31–32 Dublin III – Procedures and remedies:
    • Article 27(1) requires an effective remedy against transfer decisions; in Ireland this is provided by an appeal to the IPAT (S.I. No. 62/2018).
    • Article 29 establishes the six-month transfer deadline; CJEU judgment in AHY (C‑359/22) confirms that only the Article 27 remedy suspends that period.
    • Articles 31–32 govern exchange of information, including health data, prior to transfer (Annex IX standard health form).

3.1.2 Mutual trust and “extreme material poverty”

The judgment locates Dublin III within the broader principle of mutual trust between Member States:
  • The EU is founded on common values (Article 2 TEU) which underpin mutual trust (Jawo, para 80–82).
  • In the Common European Asylum System, including Dublin III, there is a rebuttable presumption that Member States treat asylum seekers in conformity with the Charter, the 1951 Refugee Convention and the ECHR (NS & ME; Jawo, para 82).
However, this presumption is not absolute. Drawing on Jawo and MSS v Belgium & Greece, Bradley J emphasises:
  • The threshold for finding inhuman or degrading treatment due to reception conditions is very high:
    • It must amount to a real risk of extreme material poverty, leaving the person unable to meet basic needs – food, hygiene, shelter – in a way that undermines physical or mental health or is incompatible with human dignity (Jawo paras 91–93; MSS paras 252–263).
    • Even a “high degree of insecurity or a significant degradation of living conditions” is insufficient if it does not reach this extreme threshold (Jawo para 93).
  • Nonetheless, Jawo recognises that exceptional circumstances specific to an individual – such as particular vulnerability – may mean that, even absent systemic collapse, transfer would create such extreme material poverty (para 95).
Bradley J endorses a “balancing” approach (citing Anagnostaras) between:
  • the effective functioning of Dublin III grounded in mutual trust; and
  • the need to prevent serious fundamental rights violations, whether systemic or individual.

3.1.3 Individual vulnerability and medical risk – CK and Paposhvili

The judgment carefully analyses CK v Slovenia, where the CJEU faced an asylum seeker with serious physical and psychiatric illness and recurrent suicidal ideation, in a context where there were no systemic flaws in the Croatian system. Key holdings in CK (as synthesised by Bradley J):
  • Even absent systemic deficiencies, a transfer cannot proceed if it would create a “real and proven risk” of inhuman or degrading treatment under Article 4 Charter.
  • Specifically, if transfer of an asylum seeker with a particularly serious illness would entail a real and proven risk of a significant and permanent deterioration in health, it amounts to inhuman and degrading treatment (CK, operative part para 98(2)).
  • Member States must eliminate serious doubts about the impact of transfer on the person’s health by:
    • taking necessary precautions during transport (e.g., medical escort, equipment, medication), and
    • ensuring immediate and adequate care upon arrival (Articles 31–32 Dublin III; use of Annex IX health form; prior communication and confirmation of available care).
  • If, despite available precautions, transfer would still create a real risk of significant and permanent worsening of health, the transfer must be suspended for as long as the person is unfit for transfer (para 85–87).
The ECtHR’s decision in Paposhvili v Belgium is also cited for its “serious, rapid and irreversible decline” test, further informing how Articles 3 ECHR / 4 Charter operate in medical cases.

3.1.4 The Rettinger “real risk” standard

The applicant relied heavily on Minister for Justice v Rettinger, a European Arrest Warrant (EAW) case where the Supreme Court defined the standard of proof and review in Article 3 ECHR cases. Denham J set out eight principles requiring:
  • a rigorous examination of whether there are substantial grounds for believing there is a real risk of ill-treatment;
  • consideration of all material, including independent human rights reports;
  • the burden on the applicant to adduce evidence capable of establishing “substantial grounds” for a real risk.
Fennelly J, relying on Soering and other ECtHR authority, clarified that:
  • there is no practical difference between “reasonable grounds” and “substantial grounds” – both focus on:
    • the quality of the evidence; and
    • the level of risk;
  • the applicant does not have to prove that ill-treatment is more probable than not; it is sufficient to show a “real risk” of such treatment.
Bradley J accepts that an analogous rigorous assessment is required for Dublin III transfers, but finds that the IPAT satisfied that standard on the facts.

3.2 Use of precedents in the judgment

3.2.1 Rawson v Minister for Defence – structure of judicial review

The applicant invoked Rawson v Minister for Defence [2012] IESC 26 as to what lawful decision-making entails. Clarke J’s fourfold requirements are recalled:
  1. Decision must be intra vires.
  2. Process must comply with fair procedures and any prescribed procedural rules.
  3. Decision-maker must address the correct questions, considering relevant and excluding irrelevant factors.
  4. Conclusion must be rational.
The applicant argued the IPAT misdirected itself by posing the wrong question (e.g. “whether the appellant would be able to seek medical treatment on his transfer”) instead of applying the Rettinger / CK “real risk” test. Bradley J rejects this, emphasising that the contested phrases must be read in context and that, overall, the IPAT asked and answered the correct legal question.

3.2.2 RG (No. 1) and RG (No. 2) – integrity of Dublin III and suicidal ideation

The earlier High Court decisions in RG v IPAT (No. 1) [2023] IEHC 742 and RG v IPAT (No. 2) [2024] IEHC 579 loom large in the background:
  • RG (No. 1) emphasised:
    • the integrity of the Dublin III system,
    • the strictly limited suspensive effect of Article 27, and
    • the policy concern that courts should not routinely halt transfers.
    This was a key reason for O’Regan J’s refusal of interim relief in the present case.
  • RG (No. 2) dealt with later suicidal ideation, and Hyland J observed that:
    • where a person is said to be at “high risk of suicide”, one would expect:
      • GP or psychiatric referrals,
      • specific treatment plans, and
      • active clinical management.
    • In that case, there was “very little” done between two medicolegal reports, undermining the weight of the claimed risk.
Bradley J follows this logic when observing that, in D.S.’s case, there was no evidence that he was under psychiatric care or receiving medication for mental health, and that he had not linked in with psychological services in Ireland. Like in RG (No. 2), this was relevant to assessing the reality and management of suicide risk.

3.2.3 NS & ME, Jawo, MSS – systemic conditions and extreme poverty

The judgment aligns with CJEU case law that:
  • Systemic deficiencies in a responsible Member State’s asylum and reception systems (NS & ME) can bar transfer under Article 3(2) Dublin III.
  • But even non-systemic deficiencies must reach the very severe level of “extreme material poverty” to breach Article 4 Charter (Jawo; MSS).
The IPAT and High Court apply these principles to conditions in France, acknowledging that:
  • France’s system is “far from perfect” and capacity constrained (e.g. AIDA’s finding that around 61% of eligible asylum applicants were accommodated at end-2023);
  • Yet there exists a functioning framework for:
    • reception and accommodation,
    • vulnerability screening (OFII),
    • access to healthcare and material support.
On that basis, the threshold of extreme material poverty is not reached and the MSS/Jawo exception does not apply.

3.2.4 CK v Slovenia – individual medical risk and transfer safeguards

While CK is not expressly cited by the IPAT, Bradley J holds that the Tribunal’s assessment “in substance” complies with CK. He particularly notes:
  • The IPAT considered the applicant’s specific illnesses, mental health diagnoses and claimed suicide risk.
  • The Tribunal assessed whether he would:
    • be screened for vulnerability in France, and
    • have access to appropriate medical care and procedural safeguards.
  • The Tribunal considered both:
    • systemic conditions in France, and
    • his individual circumstances (vulnerability, medical condition, medication and engagement with services).
At the transfer-implementation stage, the court views the Minister’s practices (as described by Mr Gallagher) as aligning with CK: risk is evaluated in consultation with treating clinicians; health data are shared; medical escorts may be used; and transfers are postponed or cancelled where evidence shows risk is too high.

3.2.5 Rettinger and Soering – “real risk” standard transposed

By invoking Rettinger and Soering, the applicant sought to import the EAW “rigorous examination” model into Dublin III. Bradley J accepts the relevance of these standards but finds:
  • The IPAT considered all material before it, particularly:
    • Dr Giller’s first medicolegal report, and
    • comprehensive country-of-origin and reception information.
  • The Tribunal’s central question – whether transfer would subject the applicant to inhuman or degrading treatment – is consistent with the Rettinger/Soering “real risk” yardstick.
  • On the evidence then before the IPAT (prior to the update report), the threshold of a real and proven risk was not met.

3.2.6 NVU and G & M – Dublin III as an administrative scheme of mutual trust

Charleton J’s dicta in NVU v Refugee Appeals Tribunal [2020] IESC 46 are quoted, stressing that:
  • Dublin III is designed to be a “transparent, swift and mutually entrusted” administrative scheme;
  • Exceptional rights-based objections must be factually grounded and will be “a rare exception”;
  • Ordinarily, Dublin III is about returning applicants to the Member State already responsible, not about staying or re-litigating claims in a second State.
These themes reappear in the Court of Appeal’s decision in G & M v IPAT & Ors [2025] IECA 208, which the IPAT cited. Bradley J’s judgment reinforces this model: rights-based challenges to Dublin transfers are possible but subject to a high evidential and legal threshold.

3.2.7 Procedural doctrines – Lancefort, Reid and Carter & Kenny

The State argued that the applicant had not placed CK-style arguments before the IPAT. The High Court notes:
  • As a general rule, per Lancefort and Reid, judicial review applicants should raise issues with the decision-maker, allowing for correction at first instance.
  • But this is not an absolute rule; in sensitive EU fundamental rights contexts, the court is willing to consider substance rather than strict procedural default.
Separately, relying on DPP v Carter & Kenny, the court recalls:
  • Administrative decisions carry a presumption of validity and “bear no stamp of invalidity on their face”;
  • Collateral attacks are generally prohibited;
  • Only the “right remedy” brought by the “right person” in the “right proceedings” can set aside an unlawful act.
This is particularly important for the unchallenged Article 17(1) refusal: the High Court cannot treat that as invalid or revisit it indirectly in this judicial review.

3.3 Court’s legal reasoning applied to the facts

3.3.1 The IPAT’s individualised assessment of D.S.

The heart of the judgment is an examination of how the IPAT assessed D.S.’s situation, especially in paras 4.27–4.39 of its decision. At para 4.27, the Tribunal:
  • Recited the applicant’s medical conditions:
    • HIV, latent TB, prior stomach surgery;
    • complex PTSD, severe depression, generalised anxiety disorder;
    • insomnia, fear, suicidal ideation;
  • Summarised Dr Giller’s first report and its conclusion that he is “deeply traumatised” and has expressed suicidal thoughts;
  • Noted critical contextual facts:
    • Dr Giller’s assessment was conducted online; she did not examine him in person;
    • The applicant had not linked in with psychological services in Ireland;
    • There was no evidence of a psychiatric diagnosis by a psychiatrist;
    • There was no evidence of medication for mental health.
Bradley J sees this as a bona fide attempt to assess the applicant’s actual clinical situation, not to diminish his vulnerability. In particular, it mirrors the High Court’s scepticism in RG (No. 2) about serious claimed suicide risk where no medical treatment or psychiatric intervention is in place. At para 4.33, the IPAT expressly recognised:
  • the applicant as “a vulnerable man who is depressed, anxious and who suffers from CPTSD”;
  • that he has been expressing “serious suicidal thoughts”; and
  • that, according to Dr Giller, transfer to France would present a high risk of suicide.
The Tribunal then framed the key question as:
“whether the Appellant would be able to seek medical treatment on his transfer in relation to his mental health issues and his other physical illnesses.”
The applicant criticised this wording as the wrong legal test. Bradley J holds that this sentence cannot be isolated. In context, it is embedded in:
  • a broader enquiry into:
    • whether he would have access to accommodation, food, sanitation and healthcare; and
    • whether transfer would amount to inhuman or degrading treatment (para 4.28, 4.39).
  • a sustained consideration of individual vulnerability in the light of country information.
Thus, properly read, the Tribunal was asking whether the applicant’s needs (as an especially vulnerable asylum seeker) would be sufficiently met in France to avoid crossing the Article 3 / Article 4 threshold. That is consistent with CK and Rettinger.

3.3.2 Assessment of reception and healthcare conditions in France

The IPAT analysed extensive objective material, including AIDA reports. It:
  • Recognised serious strains on the French system:
    • a significant proportion of asylum seekers are not accommodated immediately;
    • waiting lists for accommodation exist;
    • bureaucratic complexity can delay access to services.
  • Nevertheless noted that:
    • there is a legal and administrative framework for asylum reception; and
    • there is a system through which applicants can access accommodation and financial support.
On healthcare and vulnerability screening, it noted that:
  • OFII (French Office for Immigration and Integration) is responsible for identifying vulnerabilities and special needs;
  • all asylum seekers are subject to a vulnerability assessment via interview and questionnaire after registration;
  • a 2021 action plan sought to improve identification of vulnerable persons, including:
    • a network of “vulnerability referents”;
    • training for NGOs and public stakeholders; and
    • specialised accommodation places;
  • although only partially implemented, these measures have “proven to be effective in practice” according to AIDA.
The Tribunal concluded that, on the evidence, the applicant would:
  • be screened for vulnerability on arrival in France;
  • have access to appropriate medical care for both physical and mental health; and
  • benefit from special procedural guarantees due to his vulnerabilities.
Bradley J accepts this analysis and emphasises that it is consistent with the model of mutual trust and the high threshold for extreme material poverty under Jawo and MSS.

3.3.3 Emergency healthcare and initial period in France

One specific ground was that the IPAT erred in finding at para 4.35 that:
“Even if the [Applicant] cannot access the full suite of healthcare immediately, he will have access to emergency healthcare for the first three months.”
The complaint was that the Tribunal failed to consider whether emergency-only care would be sufficient to safeguard his fundamental rights. Bradley J’s approach is to look at this sentence in context:
  • It is part of a cumulative reasoning process examining:
    • emergency healthcare immediately after arrival;
    • subsequent access to full healthcare rights;
    • vulnerability screening and procedural guarantees;
    • health data sharing from Ireland under Article 32 Dublin III.
  • It is not presented as a sufficient condition by itself, but one factor among many supporting the conclusion that serious harm is unlikely.
Accordingly, the court finds no irrationality or failure to consider the adequacy of care in substantive terms.

3.3.4 Language barrier and vulnerability

The applicant argued that the IPAT did not provide a reasoned finding on his claim that language barriers in France would, combined with his vulnerability, significantly impede his ability to access necessary support, contributing to a risk of inhuman or degrading treatment. Bradley J notes that:
  • The Tribunal expressly acknowledged both:
    • the existence of vulnerability-screening mechanisms; and
    • the reality of system imperfections.
  • It was entitled, in weighing competing factors, to place weight on:
    • the institutional systems designed to identify and assist vulnerable persons; and
    • the practical utility of the existing medicolegal report for informing French authorities of his needs.
The court implicitly accepts that while language barriers are real, they do not, on the evidence, transform the applicant’s position into one of extreme material poverty or render the healthcare system effectively inaccessible so as to reach Article 3/Article 4 threshold.

3.3.5 Role and limits of updated medicolegal evidence

A crucial procedural nuance is that the update report of 3 September 2025 was not before the IPAT at the time of its decision (30 June 2025). It was obtained:
  • after the IPAT decision;
  • in response to the State’s argument at the initial injunction hearing that the first report was stale; and
  • with a view to a renewed injunction and to support the judicial review.
In that update, Dr Giller:
  • responded robustly to the IPAT’s comments on her qualifications and methodology;
  • reasserted and intensified her risk assessment, stating that transfer would:
    • likely cause “serious, rapid and irreversible decline in his mental health”; and
    • pose a significant risk to his life due to suicidal ideation.
Bradley J’s key points are:
  • Judicial review ordinarily assesses the legality of the decision based on the material before the decision-maker;
  • The High Court can, in exceptional circumstances, consider new evidence (e.g. where necessary for effective protection of rights), but here:
    • There remained a notable absence of evidence of clinical engagement with psychiatric services or active treatment;
    • Even with the update report, the Minister’s described transfer safeguards (Article 32 data sharing, case conferences, possible postponement) are capable, in principle, of eliminating serious doubts;
    • The core question remains whether there is a real and proven risk that transfer itself will cause inhuman or degrading treatment.
The judge ultimately finds that this threshold was not reached on the totality of the material.

3.3.6 Curial deference and scope of review

Although the applicant urged the court to eschew curial deference, Bradley J’s approach is measured:
  • He does not expressly adopt a “deference” doctrine; instead he:
    • restates the Rawson framework; and
    • closely scrutinises the IPAT’s reasoning for compliance with Article 3/Article 4 standards.
  • At the same time, he acknowledges that:
    • fact-finding and risk assessment are primarily for the specialist tribunal;
    • the role of the High Court is to ensure the correct legal test is applied and that the decision is rational and adequately reasoned, not to substitute its own evaluation of risk.
In practice, this amounts to a form of restrained, legality-focused review consistent with mutual trust and the administrative nature of Dublin III.

3.4 Impact and significance

3.4.1 Clarifying the CK standard in the Irish Dublin III context

This judgment is significant in consolidating how Irish courts apply CK v Slovenia in Dublin III transfer cases involving serious mental illness and suicide risk. Key points:
  • Substantive compliance is what matters: A tribunal need not cite CK expressly; what matters is whether it:
    • assesses the individual’s vulnerability and medical condition;
    • evaluates the risk of significant and lasting deterioration due to transfer; and
    • considers the availability and accessibility of appropriate care and safeguards in the receiving State.
  • Evidence of clinical engagement is central: Where a high suicide risk is asserted, courts will look for:
    • GP or psychiatric diagnoses;
    • ongoing treatment or a treatment plan;
    • prescribed medication and monitoring;
    • demonstrated difficulties in accessing care despite attempts.
    Absence of such evidence weakens the claim that transfer will cause inhuman or degrading treatment.
  • Transfer-phase safeguards count: The Minister’s operational measures – health-data sharing, case conferences, medical escorts, postponement – are treated as crucial in eliminating serious doubts and aligning with CK’s requirements.
This raises the bar for future applicants who base Dublin challenges primarily on a single medicolegal report, especially where there is little tangible engagement with mental health services in the requesting State.

3.4.2 Reception conditions: high threshold for systemic objections

Building on Jawo and MSS, the judgment confirms that:
  • Evidence of overcrowding, waiting lists, imperfect systems or even significant hardship does not, without more, meet the “extreme material poverty” threshold;
  • French reception conditions, as currently documented in AIDA and related sources, are not at the level that would bar Dublin transfers per se;
  • Applicants must either:
    • show systemic breakdown at the MSS/Jawo level; or
    • demonstrate individual circumstances that convert their situation into one of extreme material poverty or serious medical risk.
This is particularly important for litigants and advisors considering “France-based” systemic challenges: the bar remains very high.

3.4.3 Article 17(1) discretion and the limits of judicial review

The judgment also illustrates:
  • The importance of challenging adverse Article 17(1) decisions in a timely manner; once unchallenged, they benefit from the presumption of validity and cannot be indirectly reopened through a challenge to a later transfer decision.
  • That certiorari is structurally limited: even if the IPAT decision were quashed, the remedy is ordinarily a remittal, not a substantive substitution decision by the court. Therefore, the six-month time limit issue is not a trump card in itself, especially post-AHY and RG (No. 1).
For practitioners, this underscores the need for a coherent litigation strategy addressing both Article 17(1) discretion and Article 3/Article 4 grounds at the appropriate stages.

3.4.4 Operational guidance for IPAT, IPO and the Minister

The judgment contains implicit guidance for administrative actors:
  • IPAT and IPO should:
    • articulate clearly how individual medical issues and vulnerabilities were assessed;
    • link country information explicitly to the applicant’s specific circumstances;
    • address, in concise but reasoned fashion, the weight they give to medicolegal reports, especially where there is no corroborating psychiatric evidence.
  • The Minister should:
    • continue to maintain, and record, robust transfer safeguards in line with Articles 31–32 Dublin III and CK; and
    • ensure that these safeguards are explained in affidavit evidence in contested cases, as Mr Gallagher did here.

3.4.5 For applicants and advisors – evidential burdens

For future litigants, this decision signals that:
  • To succeed on a CK/Paposhvili-type challenge, applicants will typically need:
    • up-to-date, detailed clinical reports (ideally from psychiatrists and treating clinicians, not only independent psychotherapists);
    • evidence of actual or attempted engagement with mental health services; and
    • concrete evidence that the receiving State cannot or will not provide equivalent essential care, or that the transfer process itself cannot be safely managed even with precautions.
  • Merely asserting serious illness or suicidal ideation, even with a supportive medicolegal report, will rarely suffice absent corroborating medical practice and a demonstrated inability of the receiving State to respond.

4. Complex Concepts Simplified

4.1 Dublin III basics

  • Dublin III Regulation allocates responsibility for examining asylum claims among EU Member States (plus associated States).
  • When a person has passed through multiple States, Dublin III uses criteria (e.g. family links, visa issuance, irregular entry) to designate one “responsible” State.
  • Take charge request – one State asks another to accept responsibility for examining a claim (e.g. Ireland asking France, where France already agreed to take charge from Austria).
  • Take back request – a State asks another to re-assume responsibility where the person has left and re-entered another Dublin State.

4.2 Article 17(1): the “sovereignty clause”

  • Even if another State is responsible under the criteria, Article 17(1) allows any Member State to decide to examine the claim itself, as a matter of discretion (e.g. for humanitarian reasons).
  • This is not a right of the applicant; it is a power of the State. However, refusal may be reviewable on public law grounds if challenged.
  • In D.S.’s case, the Minister refused this request and that refusal was not challenged, so it stands.

4.3 Article 3 ECHR and Article 4 Charter

  • Both provisions absolutely prohibit torture and inhuman or degrading treatment or punishment.
  • “Inhuman” treatment refers to serious physical or mental suffering inflicted deliberately or by foreseeable consequences of a State action (such as transfer).
  • “Degrading” treatment involves humiliation or debasement, showing lack of respect for human dignity, or arousing feelings of fear, anguish, or inferiority capable of breaking moral or physical resistance.
  • The key question is whether there is a real risk that the person, if transferred, will face such treatment.

4.4 “Extreme material poverty”

Derived from MSS and Jawo, this concept means:
  • Being unable to meet basic needs: food, hygiene, shelter.
  • Living conditions that seriously damage physical or mental health or are incompatible with human dignity.
  • It is a very high threshold – more than hardship, insecurity or a poor standard of living.

4.5 Medicolegal reports and their role

A medicolegal report:
  • Is an expert report prepared by a doctor or other qualified professional to assist the court or tribunal.
  • Assesses physical and/or mental health, diagnoses, and causation (e.g. trauma from torture, detention).
  • Should be:
    • independent and objective;
    • clear about the expert’s qualifications and methodology;
    • transparent about what is opinion and what is fact.
In this case, the court accepted that Dr Giller is qualified to diagnose mental illness, but gave weight to the fact that:
  • there was no corroborating psychiatric diagnosis or treatment; and
  • no mental health medication or therapy was being provided despite claimed high suicide risk.

4.6 Presumption of validity and collateral attack

  • Administrative decisions (e.g. the Article 17 refusal) are presumed lawful until quashed by a court.
  • They do not “carry a stamp of invalidity” on their face.
  • One cannot normally attack such a decision indirectly in other proceedings; this is the rule against collateral attack (Carter & Kenny).

5. Conclusion

5.1 Key takeaways

From D.S. v IPAT [2025] IEHC 654, the main lessons are:
  • High threshold for Dublin III mental-health challenges:
    • Applicants must demonstrate a real and proven risk that transfer will cause inhuman or degrading treatment, either by:
      • placing them in extreme material poverty; or
      • causing serious, lasting deterioration in their health that cannot be prevented by precautions.
    • A medicolegal report alone, especially absent active psychiatric treatment, will rarely suffice.
  • Substantive application of CK and Rettinger:
    • Irish courts will look at substance over form: what matters is whether the tribunal has:
      • carried out an individualised assessment;
      • examined foreseeable consequences; and
      • applied the “real risk” standard in a rigorous way.
    • Explicit citation of CK is not required where its principles are, in substance, followed.
  • Mutual trust and systemic conditions:
    • French reception and healthcare systems, though imperfect, are not at present considered systemically deficient at the MSS/Jawo threshold.
    • The exceptional MSS/Jawo bar on transfers will only apply in cases of extreme material poverty or analogous systemic breakdown.
  • Transfer safeguards matter:
    • The Minister’s duty does not end with IPAT’s decision; health-data exchange and operational precautions are integral to ensuring transfers do not violate Article 3 / Article 4.
    • Evidence of those safeguards can be decisive in judicial review.
  • Procedural discipline and strategy:
    • Applicants should:
      • raise legal arguments (including CK-based ones) at the IPAT stage where possible;
      • challenge Article 17(1) refusals directly if they wish to rely on discretionary grounds;
      • obtain current, detailed clinical evidence and demonstrate actual engagement with treatment.

5.2 Place of the judgment in the broader legal landscape

This decision sits at the intersection of:
  • the effective operation of the Dublin III system,
  • the absolute prohibition on inhuman or degrading treatment, and
  • the increasing volume of mental-health based challenges to transfers.
Bradley J’s judgment confirms that Irish courts will:
  • take suicide risk and serious mental illness very seriously;
  • require a rigorous, evidence-based, individualised assessment by administrative decision-makers; and
  • intervene where there is a genuine real risk of Article 3 / Article 4 violations.
At the same time, the judgment protects the structural integrity of Dublin III by:
  • insisting on a high evidential threshold for exceptions;
  • respecting mutual trust and existing reception systems in other Member States; and
  • retaining a legality-focused judicial review role rather than substituting merits assessments.
In that sense, D.S. v IPAT is an important restatement and refinement of the Irish courts’ approach to Dublin III transfers in vulnerable medical cases: a demanding but principled framework that aligns domestic practice with CJEU and ECtHR jurisprudence while preserving the core functioning of the European asylum allocation regime.

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