Baby should be allowed to die, UK court rules
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《英国医生杂志》
A profoundly handicapped baby at the centre of a legal battle between her parents and doctors should be allowed to die peacefully and not be subjected to further aggressive treatment, a High Court judge ruled in London last week.
Prolonging Charlotte Wyatt's life by ventilating her if she has breathing difficulties would not be in her best interests, Mr Justice Hedley ruled, in the first dispute over a child's treatment to be heard in an open court in England.
Portsmouth Hospitals NHS Trust took the case to court after Charlotte's parents, Darren and Debbie, refused to accept doctors' conclusion that their baby, whose first birthday falls this month but who weighs only 5500 g and has failing lungs and kidneys, should not be ventilated again.
She was born three months prematurely at St Mary's Hospital, Portsmouth, weighing only 450 g and has already been ventilated five times. She has never left hospital and is profoundly brain damaged.
Baby Charlotte Wyatt should not be subjected to further aggressive treatment, the High Court has ruled
Credit: SON/NAP/REX
Doctors who gave evidence at the High Court hearing agreed that she would die within a year and would probably succumb to the first viral infection she picked up.
The judge emphasised that his ruling was only "permissive" and did not relieve the trust "of the right or responsibility for advising or giving the treatment that they and the parents think right in the light of the circumstances as they develop."
He added, "All it does is to authorise them in the event of disagreement between the parents and themselves not to send the child for artificial ventilation or similar aggressive treatment.
"Secondly, I would like to ask the treating doctors—without in any way suggesting an answer to them—to give further consideration to an elective tracheostomy on the basis of its possible contribution to Charlotte's palliative care."
Mr Justice Hedley said Charlotte should be given three things: "As much comfort as possible, as much time as possible to spend in the presence and in contact with her parents, and she should be allowed to meet her end, in the words of Mr Wyatt, with the TLC of those who love her the most."
The Wyatts' solicitor, Richard Stein of Leigh, Day & Co, said that they were "extremely upset" but felt it important that the issues had been raised in public.
The judge said that the doctors were bound to take account of the BMA's guidance on withholding and withdrawing life prolonging treatment, which, although not binding on the court, was entitled to "the closest attention and deep respect."
Michael Wilks, chairman of the BMA's ethics committee, said, "The BMA is confident that Mr Justice Hedley, after having heard all relevant information, has made the right decision in the best interests of Charlotte Wyatt."(Clare Dyer, legal corresp)
Prolonging Charlotte Wyatt's life by ventilating her if she has breathing difficulties would not be in her best interests, Mr Justice Hedley ruled, in the first dispute over a child's treatment to be heard in an open court in England.
Portsmouth Hospitals NHS Trust took the case to court after Charlotte's parents, Darren and Debbie, refused to accept doctors' conclusion that their baby, whose first birthday falls this month but who weighs only 5500 g and has failing lungs and kidneys, should not be ventilated again.
She was born three months prematurely at St Mary's Hospital, Portsmouth, weighing only 450 g and has already been ventilated five times. She has never left hospital and is profoundly brain damaged.
Baby Charlotte Wyatt should not be subjected to further aggressive treatment, the High Court has ruled
Credit: SON/NAP/REX
Doctors who gave evidence at the High Court hearing agreed that she would die within a year and would probably succumb to the first viral infection she picked up.
The judge emphasised that his ruling was only "permissive" and did not relieve the trust "of the right or responsibility for advising or giving the treatment that they and the parents think right in the light of the circumstances as they develop."
He added, "All it does is to authorise them in the event of disagreement between the parents and themselves not to send the child for artificial ventilation or similar aggressive treatment.
"Secondly, I would like to ask the treating doctors—without in any way suggesting an answer to them—to give further consideration to an elective tracheostomy on the basis of its possible contribution to Charlotte's palliative care."
Mr Justice Hedley said Charlotte should be given three things: "As much comfort as possible, as much time as possible to spend in the presence and in contact with her parents, and she should be allowed to meet her end, in the words of Mr Wyatt, with the TLC of those who love her the most."
The Wyatts' solicitor, Richard Stein of Leigh, Day & Co, said that they were "extremely upset" but felt it important that the issues had been raised in public.
The judge said that the doctors were bound to take account of the BMA's guidance on withholding and withdrawing life prolonging treatment, which, although not binding on the court, was entitled to "the closest attention and deep respect."
Michael Wilks, chairman of the BMA's ethics committee, said, "The BMA is confident that Mr Justice Hedley, after having heard all relevant information, has made the right decision in the best interests of Charlotte Wyatt."(Clare Dyer, legal corresp)