Alfie Evans 6

[CamomileTeaShotofVodka]

Following on from the last thread. If there's one already please do delete this one.

Remember not to speculate or make negative comments about the family or discussions will be stopped.

Thoughts are with Alfie tonight

Such an important and sensitive topic.

I agree that it's ridiculous that the parents haven't been given legal aid. It has caused no end of issues that people with their own agendas have entered the area so to speak.

The parents have had other legal representation, and dismissed them. At one point TE was representing himself in court because he'd sacked his legal team. The current lot only became involved at a fairly late stage, after the main proceedings had concluded and they were on to, I think, the second round of appeals.

While I agree legal aid would be good in principle - the judge in the CG case said the same - I'm not sure if it would help in all cases. The clients have to be willing to listen to their lawyers' advice.

Sorry this is the middle one

I know this has been discussed many times but I still don’t understand one point.

For someone at the eol, feeding would be inappropriate as it may cause further distress and pain due to the digestive system having shut down.

That makes perfect sense in someone ‘actively’ dying, so their Sats are low, they’ve lost consciousness etc.

However it seems that Alfie may not be at this point. 1L of 02 via nc is reasonably low, and his lack of consciousness is his baseline, not new eol behaviour. In theory it might be possible for him to continue in this state for a long time (probably until another seizure causes him to stop breathing)

So where is the line between withdrawing nutrition and actively starving someone?

If reports that he’s been resuscitated 3 tines are true, then yes he’s definitely eol, but I haven’t seen anything from an official source confirming that.

Legal aid should be available, but I’m not sure it would have changed this case once “the army” were fuelling it and a deeply emotional father was no longer able to see reason. He’s gone beyond taking reasonable legal advice (possibly why the first reputable QC we’ve seen involved was only working on behalf of Alfie’s mother.)

Legal aid lawyers would have to be provided by the state and there would have just been a merry go round of lawyers with the parents and the army insisting the legal aid lawyers were part of the problem and involved with the “corruption”.

this case has been high profile enough that I’m fairly sure he has received pro bono offers of support from decent quality lawyers. He’s either decided not to use them and favour those telling him what he wants to hear (for their own benefit), or has spoken with these pro bono lawyers but the lawyers cannot see a way forward with his mindset and have declined to act because of the reputational risk of working with them.

Can I just say those screen shots are from MEP Steven Woolfe, basically trying to start a campaign to get parents rights above children’s.

@oowatchasay Many thanks for the explanation, that makes sense.

I just want to add that this thread and the earlier ones have been so informative, measured and compassionate.

Kindest wishes to everyone who has sadly faced such a heartbreaking decision and thank you for sharing your experiences

Would legal aid be funding all of these endless appeals? Or would some sort of cut-off be applied?

Well that's the question norman. It wouldn't be in care proceedings. So for example the appeal last week on the basis that habeus corpus overrides best interests of the child wouldn't have got public funding if the parents were using it to try and challenge a care order. Because it's a totally ridiculous argument that was always going to fail. The same with Kate's free movement arguments yesterday.

However, if we create legal aid for these situations we can design the rules however we like. So we allow unlimited appeals funding, or fund one appeal, or subject it to a merits test. I favour the merits test approach. This is also used in legal aid in other areas of law.

I suspect there might be something to the idea that legal aid wouldn't have helped in this particular scenario, but then you never know.

UKIP keeping it classy...

en.m.wikipedia.org/wiki/Steven_Woolfe

Not entirely surprised he’s doing this.

Legal aid being available was discussed during the CG case. Possibly because these case are so rare it wasn’t followed up.
I am not saying at all that I agree with this but suppose the argument against it could be that there would be many more cases as unscrupulous lawyers would, as they do those involved in RTA cases, target parents.
Hopefully guidelines could be put in place to prevent this happening.

The thing with that is that, as we have had ample demonstration, parents in these cases will be targeted by the unscrupulous anyway. There isn't a way to prevent that from happening. We simply choose how we want it to happen.

At least with legal aid (which isn't available for RTA so they're a totally different group of lawyers) the lawyers will have another layer of accountability, which is to the funding body. Believe me they want their pound of flesh.

That tweet series from 'Secret Barrister' towards Liz Wheeler is quite the sexist, patronising rant. He doesn't even bother to consider the question of whether an NHS Foundation Trust is governmental or accountable to government in his haste to insult and deride Wheeler.

Whether or not this is 'government' is not to me particularly important - it's more that the point scoring ('lobotomised Trump fangirl') on social media over this poor child is rather revolting.

Utter arsehole.

And that, the spring, is how medicine works! Hcp's use evidenced based practice and rely on the outcomes of years of research. Research is carried out and, if the conclusion is that practice needs to be adapted, then practice is changed to reflect the evidence. During the case of AK the research hadn't been concluded which is why it was felt that other treatment options be explored first, now the evidence is there those options have expanded.

I'm sure you're aware that evidence changes frequently in healthcare, I undertake immediate life support every year as part of my role and every year changes have been made. This year we are told that evidence shows high flow oxygen in a patient who is peri-arrest to actually be detrimental to their possible recovery so it is no longer in the guidelines.

Sky News: the family of Alfie dispute that there's been a campaign of abuse and harassment against the staff and hospital
Well it's all very well documented so that's hardly going to wash is it.

DOOFUS, it had been researched in other countries and was being used in other countries. It was a case of the NHS being a bit slow on the uptake.

Stephen Wolfe is ex UKIP and now Independent MEP

It's the one good thing about brexit. People like him will no longer be getting an huge salary each year though it pisses me off he gets a pension.

I don't understand how they can deny that?!

And I despise all those people who are outside the hospital and protesting.

Just stop now.

The gender of the SB is unknown, but don’t let that get in the way of your assumptions, surf...

Just seen on the army page someone say that Wolfe should be prime minister as he listens to the people...

Like mightymucks has posted, having access to medical care here in the US has highlighted just how behind the NHS is in many areas.

Also, my experience with my fathers disease has been that what the NHS calls an expert and the US/Canada calls an expert are two different things.

Hcp's use evidenced based practice and rely on the outcomes of years of research yes, but surely no-one, faced with an ill child is just going to sit there and say 'well, there's a little bit of evidence X is much better for side-effects but it's not conclusive, I'll go with the old quite damaging method, thanks' are they? The NHS is sometimes slow to move on evidence anyway, plus there's never actually enough evidence often to make decisions- they wouldn't deny children radiotherapy, for example, to see if they did worse knowing it mostly makes things better, so you have to go on clinical decision-making a lot of the time as for ethical reasons RCTs can't be done.

There are a whole heap of things wrong with 'evidence-based medicine' especially in a centralized system, Ben Goldacre's work is great on this (not that I agree with everything he says). Plus in an NHS you have to show value for money against life/quality of life saved, which is why even innovative new drugs for cancer are not funded under this system.

The NHS is a good system, but it is not a great one, and if I were the parent of a child with pretty much anything, I'd be looking not just at NHS guidance and rules, but at innovative research from the entire world. I have experience of being denied treatment one year for my child and seeking it privately, when the NICE guidance changed the very next year (for a very trivial op though). I would go private again under such circumstances. Only a very obedient or a person without resources would just suck up the waiting times and the lack of technology and just accept it all without question because it's in an NHS protocol!

@CommunistLegoBloc
There is also a 'Mrs Secret Barrister' who has referred to 'him' iirc.
I love him

Fiona - with regards to the oxygen - we don't know for a fact that he is running on 1l, in fact the live videos from the room sound to me to be much higher. And of course, no one can give us an official number (rightly)

I was initially pleased this morning when it was said that the aim was to get Alfie home - this dissipated immediately when I then heard 'not dying but misdiagnosed'
That to me suggested that if he was discharged, EOL care would be eschewed in favour of some foreign Christian quack barmpot theories.

I wish nothing but peace for the three of them, I really do.

"The gender of the SB is unknown, but don’t let that get in the way of your assumptions, surf..."

Lol, are you completely serious?

twitter.com/bindelj/status/949194985756413952