An NHS organisation has been granted permission to withhold treatment from a seriously ill child.
In A Local Health Board v Y, the youngster in question was born prematurely after only seven months. ‘Y’ suffered a number of serious illnesses, including meningitis, and developed “extensive” brain damage. He remained in hospital for almost four months but was readmitted just a few weeks after going home when he developed another infection. He had trouble eating and his condition began to deteriorate.
The baby’s heart also stopped when a feeding tube was fitted and doctors spent close to thirty minutes giving him cardiopulmonary resuscitation (CPR).
A brief period of improvement in an intensive care unit was followed by further deterioration, with a poor heart rate and breathing problems. At the urging of his parents, the boy was placed back on a ventilator and feeding tube, but a continuing decline in his health meant further intrusive procedures, including the use of drugs to promote the oxygenation of his blood.
Y continued to suffer periodic heart failure. The doctors treating the youngster became convinced that the parts of his brain which controlled his heart were not functioning correctly and that the situation could only get worse. They suggested to the boy’s parents that further CPR would not be in this best interests, but his Mum and Dad urged them to continue treating their son.
The health board therefore applied to the courts for an urgent hearing on the matter. Mr Justice Baker made a number of rulings, including the appointment of a Cafcass officer as a legal guardian for the child; and gave permission for the parents to appoint an independent medical expert to advise on the boy’s prospects.
The expert chosen was a consultant paediatric neurosurgeon at Nottingham University Hospital. He endorsed the views of the doctors treating Y, as did the newly appointed legal guardian. The parents had also come round by then. They applied for an urgent telephone hearing with Mr Justice Baker and the Judge duly gave the doctors to permission to withhold treatment.
In a newly published ruling, Mr Justice Baker has now set out his reasons, explaining the benefits of withholding treatment.
“If…the doctors adopt the treatment plan proposed … the child will suffer to some extent in the short term as a result of his underlying condition, but will not be put through the cycle of suffering resulting from further deterioration, then resuscitation, to be followed by further episodes of suffering, for what the doctors regard as no clinical purpose.”
He continued:
“The doctors stress that they are not proposing the complete withdrawal of intensive care, but only the further escalation of that care. They contend that this course would allow Y a dignified life so long as he remains alive, and will not oblige him to endure further distressing compressions or other intrusive treatment if and when he suffers a further cardiac arrest.”
Mr Justice Baker’s ruling is available in full here.
