Charlie Gard 20

[CremeFresh]

Don't know if anyone else has started a new thread .

Quite agelimit. It worries me that anyone thinks they couldn't make a call about his quality of life when aware of that list of symptoms. It also worries me that unexpected recovery is mentioned in the same post. People don't seem to be able to rid themselves of that idea, do they?

Regarding Barristers - they are appointed by solicitors for their expertise in a certain field. It is quite normal for two barristers at the same Chambers to take both sides of a case. In this case there were three "sides" to be represented. There are codes of conduct where a barrister must act for their client and be separate from the other barrister who is representing the other client. Often on complex cases, few suitably experienced barristers are available at any given time to do pro bono work so it would make the choice smaller. Also family barristers at this level are fairly few in number so using one chambers is not unusual to get the correct level of expertise.

Barristers do not have to accept pro bono work. Often only the higher earners can afford to do so. This is why hundreds of people who cannot get legal aid represent themselves in court. In this case, they may have felt a change of barristers was necessary because the same chambers was acting for GOSH in the April High Court case. They did get a QC for the Court of Appeal and his juniors followed up in the most recent case, having been with the case since the Court of Appeal.

I too find it shocking that people do not understand the role of the judiciary is separate from the state.

It wasn't the same solicitors' firm. I think this conception derives from the fact that the first barrister was from the same Chambers as Katie Gollop. However, all barristers are self employed so there is no conflict; and this is not at all uncommon, especially where a number of barristers in the same chambers specialise in the same field of law. If anyone remembers Rumpole, he was frequently on the opposite side from other members of his chambers

Thank you- again. I was getting quite frustrated that a poster on here who said she was a solicitor kept reinforcing that it was the same team. I understood it to be as you describe above.

I'm rather rusty and that's from the top of my head, but I really can't think what they'd try to use to pursue legal action (Art 8 for example wouldnt cut it because his best interests had to come first

I suspect it will a straight forward Clin Neg claim on the basis that treatment could have helped Charlie earlier. I am not sure they will get anywhere with it considering the rarity of Charlie's condition and the speed of his deterioration, but still. There is no cause of action available to them as parents.

As to whether they will get lawyers pro bono, I can see Ceto's point that the resources may be too much for a firm to commit to. They may well get a direct access barrister trying to make a name for themselves.

I just really hope we don't end up there.

I also agree with whoever said that this is in no way a test case. As dreadful as it is, there is nothing legal unusual about this case - in fact, it is a pretty cut and dried case for the withdrawal of treatment.

Notice how no-one was arguing that if GOSH were right on Charlie's symptoms and pain experience that treatment should continue.

The argument was solely based on (a) whether their prognosis was correct and (b) whether treatment would help, which are factors that can only relate to this particular patient.

Nor will C&C receive any support, legal or otherwise, to amend the Children's Act to include parent's rights. Imagine the impact this would have on care cases up and down the country,

The only thing that I think we can take from this case as legal professionals is the vital role that mediation should play in these situations. As a mediator and a lawyer, I am a big fan for mediation for pretty much every dispute. Mediation before litigation every single time.

*nothing legally unusual

There just is no case in clinical negligence, it would be a complete waste of everyone's time and I'm not sure any legal team could avoid the thorny question of the other side's costs - the taxpayer/ GOSH has already had to foot one massive bill for this case.

I expect it would have to be clin neg too. Not my area but human rights is. The Article 8 argument was pretty much totally without merit. I knew exactly how those appeals would go. The question of how far the state has the right to intervene even in a way that violates the right to private and family life is a pretty settled one, really. If legal aid did exist for this type of work, I don't expect they'd have got funding for the Article 8 appeals on that basis.

In terms of mediation, I am a fan, but I think there's an argument the judge pushed it too much here. Or at least, that he was doing so with an eye more on future cases than this one. Mediation is great and there are better outcomes when it can be used successfully. But that's because parties capable of engaging in constructive mediation are parties able to work together. It's not the mediation itself that's the magic bullet, it's having the things in place that you need to make mediation successful. That very obviously wasn't the case here. I don't know how far mediation can work when there's been, for whatever reason, a complete breakdown in trust.

And what of those who have any of Charlie Gard's symptoms, dead and blind, unable to move limbs independently? People with these inflictions manage to live more fulfilled lives than some fully able-bodied people. Ask any parent of a child who has severe special learning needs and they will tell you that person experiences highs and lows like anyone else.

But what of those who have all of those symptoms, plus are in pain, unable to communicate, only living by virtue of air being forced into their lungs and constantly being suctioned? Someone on here who had been suctioned described the experience as being a horrible one, and Charlie's godfather said he showed distress at this. The evidence suggested that he was virtually beyond experience apart from some visceral pain reactions.

I guess the mediation needed to come prior to the breakdown of trust, Nightman. The hospital really need a mediator on standby for situations such as this, where an objective third party engaging in shuttle mediation at an early stage could have helped.

As the judge said, at the very least it could have helped each side understand the other's position. It may have prevented the "GOSH are murderers" angle being pursued. We will never know.

By the time that court proceedings have been threatened and Charlie's Army have been mobilised it is too late. The parents were too entrenched in their position and were unwilling to engage in the process.

But I agree that there is definitely no Article 8 argument here.

It was the judges intention to try and initiate mediation in such cases before it got to court. As was rightly said it didn't work because it was too late, but if it had been in situ before January chaired by an independent it might not have got to court.

As I understand the position, Charlie deteriorated rapidly over Christmas and the New Year and into January. GOSH looked at alternative therapies and were intending to apply for their use but then abandoned it due to Charlie's deterioration. At that point it seems trust broke down and there seemed to be a very short period where mediation could have worked because the parents believed there was a cure after contacting Dr Hirano in January. It would seem from that point onwards, there was no common ground because they believed he could be "normal" with treatment. Whether they would have accepted the realistic situation in, say October/November, we will never know.

So lessons need to be learned but you have to bear in mind not all parents will see reason in mediation. Think the e mail between doctors that the parents read was unfortunate but took out of context.

What email was that sostenueto

Yes, I think it's perfectly reasonable to emphasise the importance of mediation, but not to try and crowbar it in where it's not going to work. There's an argument about trying it in Dec or Jan (though are we sure it wasn't proposed?). However the judge said the most recent proceedings, the ones where the parents wanted him to be moved home to die, would have been better dealt with via mediation. That seems extraordinarily optimistic. What could realistically have been achieved?

I'm pro mediation, but it's not a magic bullet, and there needs to be acceptance that it's not always going to be helpful.

There was an email from the specialist in the north east to one of the GOSH ones basically saying the parents attitude was unhelpful and unrealistic, something like that. I think it was around March time.

Could there be a role for an independent link between the medical team and the parents?

Is there someone who performs this role already in situations like this? Like a police liaison officer does when someone is a victim of a serious crime?

The parents were referred to as the spanner in the works. But context of e mail was that there was no hope for Charlie even then.

There isn't an independent I don't think but they could get one in, maybe an ethisist?

The email was probably sent in January because there had been a clinicians meeting on 13 January, according to the High Court judgement in April. The judgement says the parents had been given thousands of pages of notes and this email was apparently contained in them. The judge said the comments were taken out of context and praised the Dr for their expertise and time spent looking at Charlie's condition. It was stated that if the Dr had known that the parents would be given the email, it would have been phrased differently. It referred to the fact that the parents wanted treatment (spanner in the works) and no-one else supported it. As a result it would seem the Dr might have foretold what was down the line and certainly hinted at an ongoing difference of opinion. From the judgement, differences of opinion between the parents and Gosh were already present before the email. It appears to be that the parents insisted on treatment because they thought they knew Charlie better and even Hirano disagreed with them in the April hearing.

There are media articles today that talk about setting up medical tribunals, where a panel of Drs make the final decision, and there would be no appeal process. There is good and bad in that suggestion!

The email is not quoted in full in the judgement so I assume only the legal teams and the parents had access to it. It is quoted in the judgement and a paragraph is spent on it.

goodbyestranger puts it much more succinctly than I did last night, sorry. I really do not think there'd be any case in clinical negligence. I just cannot see any way that the parents' potential arguments would work. I don't think other angles would work either.
I agree this is not about QoL because he had, what is at the present time, an incurable terminal illness.
Also sounds as though all the mediation in the world here would have been ineffective.

I do think that the email wording was in very poor taste and judgement, & too informal, despite clinical excellence and patient best interests.