Speaking about the Alfie Evans case, two renowned bioethicists and professors of medical ethics at Oxford University, have pointed out “protocol problems”. The toddler died last April [1], when the hospital withdrew his life support [2] contrary to the wishes of his parents, who wanted treatment to continue[3]. Professor Julian Savulescu, a philosopher, and Professor Dominic Wilkinson, a neonatal intensive care specialist, confirm that there are “sound ethical arguments”to change the law.
Hospitals currently assess what seems to be in the “child’s best interest” and always have the last word. In Alfie’s case, the hospital refused to attempt any additional treatment, even in another location, and decided to stop oxygen, food and water “against the parents’ wishes”. In this case, as in the cases of Charlie Gard[4] and Ashya King, “the courts based their decision on the ‘higher interest’ of the child, regardless of the parents’ wishes”, according to the two academics.
However, in other areas of law such as child custody, the only time the courts can go against the parents’ decision is when there is a risk of “significant harm” to the child. Both bioethicists use this fact to support their arguments that, in the event of a difference in opinion between hospital and parents, this concept of “significant harm” should be clearly assessed.
Without going so far as to demand that hospitals sometimes be forced to provide treatment at the parents’ request, the two professors insist, at the very least, on setting up “independent mediation” in order to “de-escalate conflict”, with “more stringent” assessment of the harm done to the child. If this change doesn’t seem enough, it’s already “a step towards finding a solution”.
Further reading:
Alfie Evans: “Liverpool Deathway”, programmed death of British patients
Terminally ill children and parental responsibility
Charlie Gard: What rights do parents have in terms of respect for the life of their child?
[1] Alfie Evans died at Alder Hey Children’s Hospital on Saturday morning
[2] Alfie: judge approves end-of-life plan against parents’ wishes
[3] Alfie Evans is still alive, his parents hope to transfer him to Rome
[4] Charlie Gard: 10 key points of the case deciphered
Bioethics Observatory (11/05/2018)