Alfie Evans is fatally ill. Should he be allowed to die in peace?

[woody2]

10 minutes ago, homarus said:

Really good debate going on now live on LBC regarding this!

 Who owns the child .the parents or the state?

nobody.....

[mojomonkey]

7 minutes ago, woody2 said:

nobody.....

I'd agree with that. Parents and government have responsibilities to a child but nobody specifically owns a child.

[Chinahand]

The issue would seem to be who speaks for the child’s interests not who ‘owns’ him. 

The court, not the state, appoints someone to represent the child. 

It would seem the main dispute is what happens if this person has a different opinion to the parents. 

 

[homarus]

Well after looking into this a little bit it seems that the Parents were the legal guardians of Alfie and had the right to move  him for treatment /care call it what you will .

 In order to overule those parential rights the Doctors at Alder Hey had to get the backing of the courts .

 Alfies  parents fought to keep their child alive ,the Medical profession fought to let him die in direct contradiction to their own hippocratic oath.

Doctors take that oath pledging  to do no  harm to their patients , so I don't really know how the judge could  justify overuling parential rights and to put a child on a pathway to death and claim and it's in the childs best interests?

 

 

 

[Gladys]

Nobody 'owns' a child.  The interests of the child are paramount and parents do not always have the best interests at heart, either through misguided ignorance, neglect or wilful abuse.  In those circumstances, the state steps in.

[Gladys]

7 minutes ago, homarus said:

Well after looking into this a little bit it seems that the Parents were the legal guardians of Alfie and had the right to move  him for treatment /care call it what you will .

 In order to overule those parential rights the Doctors at Alder Hey had to get the backing of the courts .

 Alfies  parents fought to keep their child alive ,the Medical profession fought to let him die in direct contradiction to their own hippocratic oath.

Doctors take that oath pledging  to do no  harm to their patients , so I don't really know how the judge could  justify overuling parential rights and to put a child on a pathway to death and claim and it's in the childs best interests?

 

 

 

To do no harm also means to limit suffering.  In this case, it was said that the only sense Alfie had was that of pain.  How could prolonging that be in his best interests?

[homarus]

  Please post your link to where it was said claimed the only sense Alfie had was of pain  Gladys.  In some of the updates given by his father  he was saying that his son was comfortable and responsive .

 

    "Misguided Ignorance" ?

[guzzi]

15 minutes ago, homarus said:

Well after looking into this a little bit it seems that the Parents were the legal guardians of Alfie and had the right to move  him for treatment /care call it what you will .

 In order to overule those parential rights the Doctors at Alder Hey had to get the backing of the courts .

 Alfies  parents fought to keep their child alive ,the Medical profession fought to let him die in direct contradiction to their own hippocratic oath.

Doctors take that oath pledging  to do no  harm to their patients , so I don't really know how the judge could  justify overuling parential rights and to put a child on a pathway to death and claim and it's in the childs best interests?

 

 

 

The Hippocratic Oath is a historic document that has long been superceded by much more detailed codes of medical practice and ethics promulgated by the various national medical associations.

Here's what seems to be the relevant part of the BMA's guidance. In this instance, the paragraph on patients who lack capacity must be particularly relevant, especially the reference to "their legal proxy".

 

"Weighing the benefits, burdens and risks

The benefits of a treatment that may prolong life, improve a patient’s condition or manage their symptoms must be weighed against the burdens and risks for that patient, before you can reach a view about its overall benefit. For example, it may be of no overall benefit to provide potentially life prolonging but burdensome treatment in the last days of a patient’s life when the focus of care is changing from active treatment to managing the patient’s symptoms and keeping them comfortable.

The benefits, burdens and risks associated with a treatment are not always limited to clinical considerations, and you should be careful to take account of the other factors relevant to the circumstances of each patient.

Patients who have capacity will reach their own view about what personal factors they wish to consider and the weight they wish to attach to these alongside the clinical considerations. (See the model for decision making in paragraph 14)

In the case of patients who lack capacity, their legal proxy will make these judgements with advice from you and others involved in the patient’s care. If you are responsible for making the decision about overall benefit, those close to the patient and members of the healthcare team are likely to have knowledge about the patient’s wishes, values and preferences and any other personal factors that should be taken into account. (See the model for decision making in paragraph 16.) You may also find information about the patient’s wishes in their notes, advance care plan or other record, such as an advance request for or refusal of treatment."

 

[homarus]

I'd argue that the legal proxy were the parents up until the point  the doctors disagreed with them!

 Doctors arn't always right!

 

[guzzi]

5 minutes ago, homarus said:

I'd argue that the legal proxy were the parents up until the point  the doctors disagreed with them!

 Doctors arn't always right!

 

No, it was up to the point when the Courts appointed CAFCASS as Alfie's legal guardian.

[John Wright]

51 minutes ago, homarus said:

I'd argue that the legal proxy were the parents up until the point  the doctors disagreed with them!

 Doctors arn't always right!

 

Which is why the case was taken to court, so the court could hear from the doctors, their experts and the parents and their experts and come to a decision. 

[homarus]

5 minutes ago, John Wright said:

Which is why the case was taken to court, so the court could hear from the doctors, their experts and the parents and their experts and come to the required decision. 

Fixed that for you John!

[John Wright]

47 minutes ago, guzzi said:

No, it was up to the point when the Courts appointed CAFCASS as Alfie's legal guardian.

I don't think CAFCASS was ever appointed Legal Guardian.  It acted as Guardian ad Litem  appointed by the Court, to independently represent the child's interests and with ability to and finances to obtain reports for the child to present to the Court.

There is some serious misunderstanding on here.

I don't think the court was ever addressed about or came to a decision based on cost to the NHS/taxpayer, its irrelevant.

There is a suggestion that with private rather than socialised medicine that Alfie would have continued being treated. well, that's not true, most policies have a cover level, and in the States a co-pay level . Likelihood is that Alfie would have died much sooner in a private system, unless his parents had deep pockets.

Yes some money was raised privately, but with the burn rate for that type of very expensive round the clock ventilation, drugs and feed it might have lasted a couple of months. Then what?

The parents couldn't find anyone medically qualified,  who, after reading the medical records and examining Alfie, disagreed with the diagnosis and prognosis provide by Alder Hey, namely that his brain had been destroyed and that he could never be cured or have a consciousness. If the parents had found someone then the courts would have authorised his transfer for treatment.

[Declan]

Homarus, why would the state conspire to kill some kid in Liverpool? 

The fact is it didn’t. The medical team reluctantly decided that there was nothing more that could be done and courts reluctantly concluded they were right.

 

[John Wright]

11 minutes ago, homarus said:

Fixed that for you John!

No, you just letting your personal feelings and beliefs obscure your interpretation. There was no "required" decision.

No one, any where, was able to offer treatment. He was in effect dead but being kept artificially alive. Was it in his interests to have prolonged i invasive procedures which would achieve nothing or, in the absence of any other treatment plan, and the parents had many months to find someone with a treatment plan and couldn't,   if they had the court would have let him go, or should nature be allowed to take its course.