This story really is heartbreaking, even to those of us who have experience dealing with difficult end of life cases. A boy who is not yet two years old is clinging to life in spite of the removal of life support and seemingly irreversible brain damage. Little Alfie has now survived without a ventilator for more than 72 hours at Alder Hey hospital in Liverpool. He has still been receiving oxygen.
A good summary of events is contained here (https://www.thesun.co.uk/news/4312535/alfie-evans-tom-dad-parents-alder-hey-hospital-what-wrong/)
First, the legal analysis: Alfie has been described as being in a "semi-vegetative state", which would mean that he is still neurologically alive by the standards accepted pretty much everywhere in the Western world. Medical staff have decided to withdraw treatment from Alfie because there would be no further purpose served - in their estimation - to continuing treatment. We often hear in legal speak that further treatment is "not indicated". The courts have upheld the law by affirming that doctors and other medical staff may not be compelled to provide treatment that is not believed to have a benefit. It is also important to note that in most western jurisdiction, including England, patient and/or their families cannot order a physician to provide a treatment. The US media sometimes mixes up this concept in Canadian and British cases because they assume that the reason for such a ruling is that the individual does not have the ability to seek the medical services in the private sector and thus is being punished by the socialized medical systems in those countries. This is not accurate. No doctor can be forced to provide a treatment that is not medically indicated and that could be perceived to be harmful, abusive or inhumane to the patient. Where the conflict really takes place is in the interpretation and application of such standards.
These types of cases are simply brutal. Medical staff are often overly paternalistic and have a hard time empathizing with the plight of the family. Families are overcome with grief and unable to accept the medical and scientific realities present. Medical legal standards related to end of life and determination of death have been created with ethics, morality, spirituality and humane care in mind; an attempt at bridging the gap between science and faith. But the sides often seem to be at opposite poles in such disputes. (These are my general observations from experience. I have no intimate knowledge of the individuals involved in this particular case).
Where this case takes a sad legal turn is in the British court system wanting not only to uphold the medical legal standards but in overreaching regarding how the little boy should be cared for following the removal of life support. They have blocked his parents from taking him for further treatment in Rome (which was to be supported by the Vatican) and have allowed the medical staff to make it difficult for his parents to even take him home. I can only assume that they are relying on the notion of child protection to rationalize these decisions. This young man does not, however, need protection from his parents. That is the furthest thing from the truth. His parents are doing everything they can to save him.
It now appears that they are trying to find a way to take him home. They believe that he has been wrongly diagnosed any may survive for some time without ventilation. I hope they are right! They certainly should be able to take him home, as they put it, to live, not to die. Hopefully, this will come to pass. The rest will be in the hands of fate. Now that the courts have enforced the law as they see fit, Alfie's parents should have the freedom to determine how the next steps unfold for the little boy who they evidently love more than anything.
In the meantime, God bless this little boy!
CW
