Archie Battersbee case

[whynotwhatknot]

I was just wondering why we're not allowed to post about this case-the deletion message mentioned it was ongoing so wouldnt be fair to the family

Charlie gards case was on going and there was numerous threads about it

Anyway if this stands maybe we can discuss

I do wonder how much psychological
help was made available for his family when he was admitted. It’s become a completely gruesome farce which I think covid have been avoided.

AND i don’t understand why further appeals are being allowed when they would be so kinder to end the debate. There is no real debate to end to be had. He is dead.

I think vasopressin also controls blood pressure and keeps it up?

Absolutely.

In any event, the judges seemed to be refusing to go there on the basis that that is a matter for careful medical evaluation and not something the law can get involved in. Which makes perfect sense.

It's also called ADH - anti-diuretic hormone

It causes your kidneys to become more permeable and reabsorb water into the blood - important for regulating water levels in the blood and maintaining blood pressure

Patients with diabetes insipidus who don't respond to hormone therapy have to drink something like 20L water a day, because it just pours straight out of them.

If they stopped the vasopressin then he would produce vast quantities of urine which would drop his potassium, sodium and his blood pressure due to hypovolaemic shock. He would either go into cardiac arrest due to low potassium or loss of blood pressure. It would be drawn out and he would still also be attached to all the wires and tubes making it difficult to hold him. Removing his art line and central line can take a while as you can't just pull it out. You have to apply pressure for at least 15 mins sometimes longer or he will bleed out all over the place. That's why a planned withdrawal is better. You can remove everything but the vent. Wash and dress him and mum can be on the bed cuddling him when they remove the breathing tube

I think I missed this - but were the family arguing for his death to be caused by withdrawal of vasopressin treatment?

Why on earth would they want this? His team clearly know the most peaceful way to remove life supporting care.

I am hopeful the court of appeal will substitute if the appeal succeeds. A third hearing on the same thing, and undoubtedly another attempt at appeal thereafter, is just ridiculous

Quite - and as you say, it's become more than clear that they'll just go on appealing no matter what the logic of the situation

For obvious reasons I honestly do get why the system enables this, but surely there's got to be a limit somewhere?

I wonder whether they’re arguing for removal of vasopressin to get the doctors to say “no, that’s a bad thing to do” (which we know is because it would be an undignified and chaotic way to stop his heart) which the family can then twist into “the doctors are saying treatment should continue”.

Would the medical team even agree to that kind of death?

I'm not sure if they're trying to restart the whole case or they think he'll be able to survive without the vasopressin. Hollie posts a lot on the group about how his vasopressin has been reduced so I think she might think he stands a chance without it - she's trying to prove that he's recovering. Maybe someone will ask on the group and she might answer but I think they generally boot anyone who brings up the court proceedings apart from the generic 'good luck today' messages.

Someone on there has posted how dare they judge suggest they've accepted he won't wake up...why would they think the judge has suggested it?! And how he'll prove them wrong. Hard as it is should be time to mum to admit to the group her thoughts rather then delete anyone who brings up what's been said in court.

That's quite bizarre. Do they really think that the judge came out with something like that and Hollie's lawyer didn't bother to put him right if it was so incorrect?

It's really quite worrying that they are deliberately doing their best to keep the truth from their supporters by deleting every post that mentions anything inconvenient from the judgments or the recordings of the Court of Appeal hearings. It's a complete betrayal of trust, but sadly they know they will ge away with it in an awful lot of cases because people won't bother to check and don't understand enough of the basics of the legal system to question what they say.

Mind you, posts on the Christian Legal Centre's FB pages are another realm of batshit. They basically dismiss anything they don't want to hear by saying that God can do miracles and we must all pray to him. It seems to occur to none of them that if there is a God, and if he had any hand in this, it happened back in April when he failed to stop Archie from injuring himself.

Hollie posts a lot on the group about how his vasopressin has been reduced

My interpretation was that I didn’t think she understood how concentrations work. At one point she was pleased because he was receiving a 10% infusion of vasopressin, she seemed to think that meant he was making the other 90% himself. When of course it just related to the concentration of vasopressin hormone added to the saline, or whatever.

As an aside about vasopressin/anti-diuretic hormone, it’s also the hormone implicated in children who bed wet. We naturally produce more overnight, resulting in lower volume, more concentrated urine. Some children’s bodies take longer to work it out so soak themselves/the bed with higher volume, dilute urine. The most useful treatment is time/maturity but for social emergencies like sleepovers and camps there are synthetic forms of the hormone, initially as a nasal spray, now as a waiter that work for most children.

Maybe this is a case of “the family knows best” and they have become accustomed to the fluid corrections, hormone corrections and electrolyte corrections and secretly don’t think he needs them anymore?

if they asking for vasopressin to be withdrawn only is that because she thinks he will survive without it or just a delaying tactic

Thing is also people have said it's in the court transcript etc. Then someone else will come along and say its lies and only believe what is posted on that group so there is no helping them anyway. That was before this one and before posts started getting deleted.

The posts of can't wait to see him wake up and he'll show the doctors how wrong they are etc just seem odd when it's clear he won't

I don’t know. If a delaying tactic it wouldn’t delay things for that long and I think it would be horrible to watch. presumably all the other lines and monitors would come off, so you wouldn’t see the BP drop and/or heart rhythm change from low potassium but you’d be aware of the huge volume of urine loss.

Maybe she genuinely thinks he can survive without it?

Maybe she thinks he can live without it, and maybe it is a way of trying to get the CA to send it back to reconsider again.

Archie’s withdrawal of care and “death” could be so carefully managed and beautifully managed, his loved ones all around him, favourite music playing, peaceful last moments with the chance to remember him in a lovely way. Instead I worry it will be alarms and abnormal heart rhythms and cardiac arrest and hugely distressing for everyone involved. And traumatising for his family.

I have been involved more than I care to remember in both. One recently was so beautiful with family members with the patient as they died and I got to hear them tell stories and share what a wonderful person they were.

I hope Archie gets to “die” with some dignity.

(Yes I know he is likely already dead but death by neurological criteria can’t be confirmed as they couldn’t perform testing)

Withdrawal of care should have been withdrawal of treatment, in his case ventilation. Apologises,, typed one bit and then changed it and didn’t change that. We never withdraw care because we care for patients as they die and even after they die.

That is all anyone can hope for now. But then the family came out of court last week and announced that they "don't believe in a dignified death".

The death they want will be chaotic. He has a DNR in place, so alarms will go off and the family will have to watch him rapidly deteriorate whilst the staff do little. I honestly don't think they will sit by and think "this is it". I think they will shout and scream and want him to be resuscitated.

Unlike most deaths, they have the chance to plan it and gather people round, tells stories and share memories. Mum can cuddle Archie, unhindered by masses of tubes.

I don’t think there can be a precedent set where families can say, we’ll, we’ll withdraw X but not Y.

I think Hollie thinks he doesn’t need the vasopressin, based on her posts.

I think the Christian legal group don’t want ventilation to be ordered to be stopped as this may help them in cases to come. Archie’s body is too unstable to survive without the fluid and hormonal support but in the future there may be cases like Jahi McMath who was home ventilated for 5 years.

i agree with the PP who said Hollie thinks he doesn’t need the vasopressin anymore (she was on TV talking about how it has reduced/how she believes he communicates with his Blood Pressure) which is why they are saying they would withdraw that.. Luckily withdrawal of treatment is not a pick & mix and will be led by the hospital/guidance for end of life care.

If that is not the case re: the vasopressin, what is suggested is that actually they want A to have a “natural” death which is likely to be chaotic, more distressing (for them) and potentially without the people there who want to be with him all because of a belief in God which didn’t exist before A was in hospital according to what I’ve read? I just can’t imagine that would be the case? Sadly the longer this goes on at court with them being there all day, the higher the chance that actually H won’t be there when he dies.

I get the impression that it started with the first but became the second. It appears that some time before the last hearing the lawyers wrote to say they would be putting forward a third proposal, i.e. continuing ventilation but withdrawing vasopressin, and I'm guessing - and it's a total guess - that Hollie thought Archie would be OK and that that would bolster her case that he is doing really well so ventilation should be continued. Then they called Dr F who said it would just be a slightly slower way of precipitating a quick and unpleasant death, and the lawyers thought or assumed they should therefore drop that.

However, they were then faced with the Court of Appeal's proposal that, if they allowed the appeal, they could remake the decision rather than remit it for rehearing, and wanted to argue that that wasn't possible because, amongst other matters they hadn't heard Dr F's evidence. The judges' response to that was, essentially "But Dr F mainly gave evidence about the vasopressin option which you aren't pursuing anyway so why do we need to hear him?" So they had a rapid rethink and decided to say that they were pursuing it in the hope of getting a rehearing which will give them at least a couple more more weeks whilst going through that hearing and the next appeal.

But it looks like it won't work because the judges said that, irrespective of Dr F's evidence, there was no way they could get into decisions about withdrawing individual types of treatment, that's for doctors not the court.

One of her latest videos said about Archie's BP being the same as a healthy child.. like that meant he is healthy too.
She is either in denial or ignorant as to what all the meds and interventions are doing for her son. It is painful to watch this going on now.
I know about the Jahi case. Hollie wont get to take Archie home though. He wont make it out of his room.

I know about the Jahi case. Hollie wont get to take Archie home though. He wont make it out of his room

Im sure the Christian legal team know that too, but it may help them with other children. It was a similar-themed legal argument that enabled Jahi to stay on long-term ventilation (beating heart = living soul).

So they had a rapid rethink and decided to say that they were pursuing it in the hope of getting a rehearing which will give them at least a couple more more weeks whilst going through that hearing and the next appeal

This could well be right, and it’s all about more time rather than the legal team having a wider agenda. I may be more suspicious of them than is warranted.

Although the pro bono legal team still definitely went into this with an agenda, by stating they wanted to change the “definition of death”, it’s just that it was largely scuppered by the legal segue into “best interests” and a move away from definition of death.