When deciding whether life-preserving treatment should be withdrawn from severely brain-damaged patients, family judges often have to strike a difficult, if not impossible, balance between religious beliefs and medical science. As one case showed, however, the patient’s welfare is always their guiding light.
The case concerned a baby boy who suffered a cardiac arrest in his cot and endured about half an hour of oxygen deprivation before his arrival at hospital. A diagnosis of brain-stem death was made. However, that was later rescinded after he showed signs of respiratory effort indicative of some brain-stem function. The NHS trust that bore responsibility for his care nevertheless sought judicial authorisation for his withdrawal from mechanical ventilation.
His parents were united in their religious conviction that life should be promoted at all costs. They agreed that it would be the will of God if his heart were to stop, and that he should not in that event receive CPR. Removing him from ventilation, however, would be an active step contrary to their beliefs.
Ruling on the matter, the High Court recognised that the culture and faith into which he was born was an important factor. The central tension in the case, which had taken a great toll on the parents and treating clinicians, was between faith and medicine. The matter involved balancing concepts which were at the very least difficult – some might say impossible – to reconcile.
The unique value of human life, the Court acknowledged, does not dissipate where awareness diminishes, or where the capacity of the brain becomes so corroded that all autonomy is lost. It is perhaps in such circumstances that the sanctity of life requires the most vigilant protection.
In granting the trust the declaration sought, however, the Court noted that it was required to focus unwaveringly on the boy’s best interests. The evidence was clear that he was dying and that continuing ventilation would merely protract that inevitable process. The possibility that he felt pain could not be excluded and persisting with ventilation would confer harm without conveying benefit. The Court directed that he should continue to receive palliative care.