When I was nine years old, I spent almost a year of my short life at the Alder Hey Hospital in Liverpool, where I was cured of tuberculosis. The care and treatment I received from the doctors, nurses and strict matrons of those days was of the highest quality available at the time, and I am still grateful for that. Not only did it heal me, but it also meant that I was never afraid of hospitals that have infested some people. My time at the hospital also gave me a lifelong addiction to reading.
So, I paid some attention to the case of Alfie Evans, the little boy whose brain was largely destroyed by a mysterious illness and who is dependent on it for his life on feeding and breathing machines in the same hospital. This life seems likely to end in the next few days as a succession of British and European courts have refused to allow his parents to remove him from Alder Hey to be treated either at home or in an Italian hospital. The last legal change took place today when the European Court of Human Rights refused to hear one last complaint from their parents. That means a judgment from the UK Supreme Court will apply from three days ago, Alfie will stay with Alder Hey, the machines that keep him alive will be shut down, and Alfie will die very soon.
The final judgment of the United Kingdom The Supreme Court can be read here.
It is a brief summary of the case and legal facts of the case, clearly written and readable. Much is commonly agreed by all parties ̵
But there are two important issues that need to be unpacked. The first is that, as the courts say in several ways, the interests of the child, Alfie, should be "paramount". This is the "gold standard" of jurisprudence in cases of minors, whether a custody order in a divorce case or dispute over the child's medical care as here. This gold standard is the rule not only in the UK, but also in Europe and internationally, which, as the court says, strengthens the power of its decision in this case.
One obvious problem with this argument, however, is that Alfie is both a minor and unable to judge his own interests. Until recently – in fact, I think it is still listed in the Universal Declaration of Human Rights – parents had the right to determine what was in the child's best interests. In its judgment, the court referred to this right and pointed out that the Custody Act of 1891 considerably restricted this parental right (and, by the way, also its duty). For example, the courts would not give custody to a parent if he had left or left the child, or behaved in any way to show it was a danger to the child. This amendment was later reinforced by other parliamentary laws, with the overall result that the state is now exercising parental authority over the child while, to some extent, leasing this right to the actual parent. For example, this "gold standard" of the "primary" interests of the child is the basis for intervention by the courts to prevent parents, mostly for religious reasons, from refusing blood transfusions necessary to save a child's life.
That's not what happens here. It's Alfie's parents who want to continue the medical services that keep Alfie alive, and it's the courts that insist on turning off the machines. The court expressly states this in relation to previous court decisions: "After careful consideration of the evidence, it was decided that it was not in his best interest to continue the treatment that sustained his life or that he is taken to another country with an ambulance for this purpose . "And it is far from clear that the court's decision is in Alfie's interest or that it should be the court's decision at all.
After all, the court itself acknowledges that Alfie's actual parents are good and loving parents. They are not the brutal, cold or negligent parents who in 1891 justified the transfer of parental rights to the courts. On the contrary, they have heroically sought out other doctors and another hospital that will treat their child – and they have succeeded. Why should not they be judges or doctors, but the best judges of Alfie's overriding interests?
And this question gains strength through the court's decision. It's finally a death sentence. From what does Alfie save? He does not seem to be in pain. The removal of Alfie from an Italian hospital would not prevent other young patients in Alder Hey from benefiting from the medical treatments he is currently receiving. The reason seems to be that both the court and the doctors feel that he will never recover or live without the constant help of advanced medical care – and that it is pointless to keep him alive longer.
This argument is not necessarily absurd. Most people would agree that the person in charge of taking care of Alfie is not morally obliged to maintain heroic medical treatment indefinitely. However, you are entitled to do so if you wish. And Alfie's parents want to do everything they can to keep their son alive as long as it is possible in the hope of a miracle. It should be their decision, not that of judges, however high they may be, or of doctors, however clever they may be.