Hospital breached boy's human rights by treating him against his mother's wishes
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《英国医生杂志》
BMJ
The human rights of a 12 year old boy with profound disabilities and his mother were violated when doctors overrode her wishes and gave him diamorphine, the European court of human rights ruled last week.
The unanimous ruling confirms that doctors cannot impose treatment on a child against a parent's wishes. If the parent refuses consent, the court's approval must be sought.
Carol Glass told doctors she wanted her son David, who was in St Mary's Hospital in Portsmouth in 1998 with a respiratory tract infection, to be resuscitated if his heart stopped. But doctors put a "Do not resuscitate" order in his medical notes without telling her.
Earlier in the year, he had spent 23 days on a ventilator, but this time doctors decided not to intervene but recommended diamorphine to ease his distress. His mother refused to believe he was dying and turned down the diamorphine, fearing it would compromise his chances of recovery.
David was born with hydrocephalus, has spastic quadriplegia and severe learning disabilities, and is virtually blind. His mother asked to take him home if he was dying, but the police were called and told her she would be arrested if she tried to remove him. Doctors gave him a low dose of diamorphine, but a group of his relatives entered the ward, assaulted doctors, removed the tubes, and resuscitated him.
The court awarded David, who survived and is now 17, and his mother a total of ￡7000 ($12 640; 10 300) in damages and ￡10 500 in costs—payable by the UK government—for a breach of article 8 of the European convention on human rights, the right to respect for private life.
The judges said: "The court considered that the decision to impose treatment on David in defiance of his mother's objections gave rise to an interference with his right to respect for his private life, and in particular his right to physical integrity."
Doctors gave diamorphine to David Glass (left) against the wishes of his mother Carol, pictured outside the High Court in 1999
Credit: NEIL MUNNS/PA
Credit: JOHNNY GREEN/PA
Mrs Glass sought a High Court declaration in 1999 that it would be unlawful in future for doctors to treat her son without her consent. But the High Court, and later the Court of Appeal, refused to grant a declaration covering a hypothetical situation.
However, Lord Woolf, then master of the rolls, said a court must be asked to decide when parents and doctors are in "grave" conflict over a child's treatment.
The Strasbourg judges said they had not been persuaded that an emergency High Court application could not have been made. Instead the doctors and hospital officials used the limited time available to try to impose their views on Mrs Glass.
The family's solicitor, Richard Stein, said: "Except in lifesaving emergencies, this judgment confirms what we all thought the law was. If doctors want to override parents' wishes they have to go to court. We hope the few recalcitrant doctors who want to treat children against their parents' wishes will think again."(Clare Dyer, legal corresp)
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The unanimous ruling confirms that doctors cannot impose treatment on a child against a parent's wishes. If the parent refuses consent, the court's approval must be sought.
Carol Glass told doctors she wanted her son David, who was in St Mary's Hospital in Portsmouth in 1998 with a respiratory tract infection, to be resuscitated if his heart stopped. But doctors put a "Do not resuscitate" order in his medical notes without telling her.
Earlier in the year, he had spent 23 days on a ventilator, but this time doctors decided not to intervene but recommended diamorphine to ease his distress. His mother refused to believe he was dying and turned down the diamorphine, fearing it would compromise his chances of recovery.
David was born with hydrocephalus, has spastic quadriplegia and severe learning disabilities, and is virtually blind. His mother asked to take him home if he was dying, but the police were called and told her she would be arrested if she tried to remove him. Doctors gave him a low dose of diamorphine, but a group of his relatives entered the ward, assaulted doctors, removed the tubes, and resuscitated him.
The court awarded David, who survived and is now 17, and his mother a total of ￡7000 ($12 640; 10 300) in damages and ￡10 500 in costs—payable by the UK government—for a breach of article 8 of the European convention on human rights, the right to respect for private life.
The judges said: "The court considered that the decision to impose treatment on David in defiance of his mother's objections gave rise to an interference with his right to respect for his private life, and in particular his right to physical integrity."
Doctors gave diamorphine to David Glass (left) against the wishes of his mother Carol, pictured outside the High Court in 1999
Credit: NEIL MUNNS/PA
Credit: JOHNNY GREEN/PA
Mrs Glass sought a High Court declaration in 1999 that it would be unlawful in future for doctors to treat her son without her consent. But the High Court, and later the Court of Appeal, refused to grant a declaration covering a hypothetical situation.
However, Lord Woolf, then master of the rolls, said a court must be asked to decide when parents and doctors are in "grave" conflict over a child's treatment.
The Strasbourg judges said they had not been persuaded that an emergency High Court application could not have been made. Instead the doctors and hospital officials used the limited time available to try to impose their views on Mrs Glass.
The family's solicitor, Richard Stein, said: "Except in lifesaving emergencies, this judgment confirms what we all thought the law was. If doctors want to override parents' wishes they have to go to court. We hope the few recalcitrant doctors who want to treat children against their parents' wishes will think again."(Clare Dyer, legal corresp)
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