Wednesday, April 25, 2018

Alfie Evans

From the BBC:
"Who is Alfie Evans and what is the row over his treatment?"

Life support for seriously ill toddler Alfie Evans has been withdrawn following a lengthy legal battle between his family and the courts. The fight has attracted widespread media attention and seen his parents clash with doctors over the youngster's care. This is how the story unfolded.

Who is Alfie Evans?
Alfie was born to parents Tom Evans and Kate James, from Bootle in Merseyside, on 9 May 2016. He was first admitted to Alder Hey Children's Hospital in Liverpool in December 2016 after suffering seizures and has been a patient in the hospital ever since. Doctors diagnosed a degenerative neurological condition which they have not been able to identify definitively Alfie's parents and the hospital have clashed over what should happen to Alfie, who has been in a semi-vegetative state for more than a year His parents said they wanted to fly him to a hospital in Italy but this was blocked by Alder Hey, which said continuing treatment was "not in Alfie's best interests".  The Alder Hey Children's Hospital NHS Foundation Trust went to the High Court to seek a declaration that "continued ventilator support is not in Alfie's best interests and in the circumstances it is not lawful that such treatment continue". Sitting at the High Court in Liverpool, Mr Justice Hayden began overseeing the case on 19 December. Alder Hey said scans showed "catastrophic degradation of his brain tissue" and that further treatment was not only "futile" but also "unkind and inhumane". But his parents disagreed and wanted permission to fly him to the Bambino Gesu Hospital in Rome in the hope of prolonging his life. The Italian hospital, which has links to the Vatican, suggested operations to help Alfie breathe and keep him alive for an "undefined period". The judge said he would make a decision on what was best for Alfie if an agreement was not reached.

Who decides?
One of the dilemmas Alfie's case has raised is whether doctors are the right people to determine whether withdrawing life-support treatment is in "the best interests" of a terminally ill child.  One of the key arguments presented by his parents was that they should decide what is best for their son.  It was the same case made by the parents of Charlie Gard, the 11-month-old baby who died last year following a similar battle over his treatment.  The law in the UK falls somewhere in-between. The 1989 Children's Act makes it clear that where a child is at risk of harm the state can and should intervene. This means that the rights of parents are not absolute and the state has been emboldened to challenge the view of parents where they believe a child's best interests are not being served. If a public body disagrees with the parents' choices, they must go to court in order to override this parental responsibility.

What did the judges rule?
Mr Justice Hayden said doctors could stop providing life support for Alfie against his parents' wishes, saying the child required "peace, quiet and privacy". Mr Evans said he believed his son was still responsive, telling reporters outside court Alfie was "improving". But Michael Mylonas QC, representing the hospital, said: "One of the problems of this case is they [Alfie's parents] look at him and, barring the paraphernalia of breathing and feeding, he's a sweet, lovely, normal-looking boy who opens his eyes, [and] will smile..."  The hospital asserted that any movements by the child were "spontaneous seizures as a result of touching". Mr Justice Hayden ruled in favour of hospital bosses on 20 February and doctors were set to withdraw ventilation on 23 February before his parents embarked on a lengthy legal battle.

How the case unfolded
Alfie's parents refused to give up hope and took the case to the Court of Appeal on 6 March where judges upheld Mr Justice Hayden's decision. On 20 March, the couple appealed to the Supreme Court where justices refused to give the couple permission to mount another appeal. Despite this, their lawyers went to the European Court of Human Rights (ECHR) after exhausting all legal avenues in the UK. But three judges ruled the submission "inadmissible", saying they were unable to find any violation of human rights.  On 11 April, Mr Justice Hayden then endorsed an end-of-life care plan for Alfie, setting a date to switch off life support.  Lawyers for Alfie's parents began a final legal bid to take control over the treatment of their son on April 16, claiming he was being "unlawfully detained". But this was rejected for a second time by the Court of Appeal and the Supreme Court.  On 18 April, Mr Evans flew to Rome for a meeting with the Pope, pleading with him to "save our son".  Despite an urgent application to the ECHR on Monday, judges refused to intervene in the case, prompting angry scenes at Alder Hey Children's Hospital.  Within hours, the Italian Ministry of Foreign Affairs granted 23-month-old Alfie Italian citizenship, hoping it would allow an "immediate transfer to Italy". Pope Francis then tweeted his support for the family: "I renew my appeal that the suffering of his parents may be heard and that their desire to seek new forms of treatment may be granted." But this last-ditch appeal was dismissed by Mr Justice Hayden who stated that "Alfie is a British citizen" who "falls therefore under the jurisdiction of the High Court." The Italian Embassy has since clarified it was not trying to challenge any decisions made previously by the British courts.  A spokesman described the granting of citizenship as a "signal" to the judge that should he change his mind, they are ready to facilitate his transfer to the Italian hospital.  A further hearing then took place on Tuesday afternoon in which Mr Hayden said the case had now reached its "final chapter". He rejected claims by Mr Evans that his son was "significantly better" than first thought because he had been breathing unaided for 20 hours after doctors first withdrew life support. Alfie's parents then launched a further appeal against the order stopping them from taking him to Italy, which will be heard on Wednesday afternoon by a panel of three Court of Appeal judges, headed by Sir Andrew McFarlane.


^Another Socialist death panel (again in the UK.) It would be one thing if 1 parent was for and 1 against but both parents are for treatment. It is the doctors and the judges that are refusing treatment or even for him to go out of country so it wouldn't cost the Brits any more money. Well done NHS. If you want to have no control over your own life or the life of your children then you should move to the UK where uncaring doctors and uncaring judges will decide what you want (and base most of it on saving money rather than saving your life.) It is illegal in the UK for doctor-assisted suicide, but legal for doctor-judge "death panels." Go figure. ^


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