04 April 2014

Mr Justice O’Hara, sitting in the High Court in Belfast, today ruled that medical staff responsible for the care of a 5 month old baby, referred to as M, are permitted to remove him from a ventilator and should not resuscitate him if the need arises.

M, who was born in October 2013, was involved in an incident on 7 March 2014 which caused his heart to stop. He was taken to hospital where doctors managed to get his heart started again but his brain had been starved of oxygen.

The Judge heard evidence from the doctors caring for M that he has suffered such overwhelming and irreversible brain damage that in all likelihood he is now blind, deaf, severely mentally handicapped and severely physically disabled. It is likely (but not certain) the brain damage is such that he is not in pain. He is currently being kept alive by a ventilator because it is believed he could not breathe unaided for more than a short period of time. Successive scans have shown no improvement. The doctors believe M can never recover to any form of living which does not involve continual ventilation; he would not be able to interact with anyone and would have no recognisable quality of life.

M’s parents do not want the ventilator to be switched off. His father, whose distress and desperation the Judge acknowledged as being almost unimaginable, had sent video clips of M in intensive care to a “controversial figure”, Professor Z, who claims to specialise in the rehabilitation of patients in another country. The Judge heard evidence from Professor Z that he was of the opinion M could make a recovery if he was treated with, amongst other things, a technique of neuro-stimulation designed and demonstrated by him.

M’s doctors described the supposed neuro-stimulation demonstrated by Professor Z as being little more than massaging M’s face, head and limbs.

The Judge rejected the evidence of Professor Z that his neuro-stimulation technique would in any way start to reverse the brain damage and considered his evidence had merely given a distressed, grieving family false hope where there was none.

The Judge said that since M does not have the ability to make the decision himself, the law requires the Court to decide whether it is in his best interests that his life should be prolonged by the continuation of the present medical treatment. He also emphasised that it is not an application by the doctors to take a positive step to end the M’s life (e.g. by injecting him with a drug); rather it is an application to withhold treatment (ventilation) which is prolonging M’s life artificially.

The judge recalled how the parents had powerfully and movingly expressed their wishes to him before concluding:

“The starting point must always be that life should be preserved and continued other than in exceptional circumstances. Added to that side of the balance are the parents’ wishes and the support and commitment of the extended family. Regrettably the other side of the scales is much heavier. The extent of the damage to M is such that he has and will have no quality life, he will always be dependent, his physical condition will deteriorate and he will be prone to complications which will require further treatments. In short he has no meaningful life and no dignity nor will he have in the future. The prolongation of his life by ventilation can achieve nothing other than prolongation of life for its own sake. In circumstances of this case I do not believe that is enough.”

Mr Justice O’Hara granted the application and further ordered that the best possible palliative care should be provided to M.