A paper in the British Medical Journal has called for “new solutions” to disputes between parents and doctors on medical care, in the wake of the Alfie Evans case.
Two bioethicists have argued there are “strong ethical arguments” for changing the law; Professor Julian Savulescu, a philosopher, and Professor Dominic Wilkinson, a specialist in newborn intensive care, both teach medical ethics at the University of Oxford and have argued that the case showed there are problems with the current protocol.
Alfie Evans died in April, aged 23 months, after suffering from an undiagnosed degenerative brain disease.
His parents had been locked in a prolonged legal dispute with Alder Hey hospital. Doctors believed further treatment for Alfie would be unkind and inhumane. The High Court ruled the hospital could stop providing life support, against his parents’ wishes; they’d wanted to move him to the Vatican-owned Bambino Gesù children’s hospital in Rome but were barred from doing so.
The two academics noted that in this case, as in other medical disputes, courts based their decision on the child’s “best interests” irrespective of the parents’ wishes.
However, in other areas of law, such as custody, courts can only overrule parents if there is a risk of “significant harm” to the child. The bioethicists say there are “strong ethical arguments” for changing the current law on medical disputes to a “significant harm” test.
The paper rejected the idea that parents could force medical professionals to give treatment against their will. But it argued that “independent mediation” has been shown to “de-escalate conflict” by trying to resolve disagreements before they come to court. They did not speculate on whether this would have led to a different verdict in the Alfie Evans dispute, but said it would be a “more stringent” standard for courts to meet if parents’ wishes were to be overridden.
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