Won the right to appeal…worried about outcome (Archie Battersbee)

[WhatsHoppening]

Firstly I can’t imagine the parents pain and I understand they are deeply grieving and are desperate. They’ve been led on by the Christian charity lawyers and are very vulnerable. I also understand the want to fight to the death for your child even if I disagree with it personally.

As a HCP I am very concerned if the next court case rules in favour of the family and to continue to keep the poor child ventilated/continuing intervention. My perspective as well as anyone I know in healthcare understands he is brain dead and deteriorating. Caring for a patient like that would be traumatic for the staff although of course that’s not the point.

If we allow families to ‘choose’ whether people continue to be ventilated against medical advice this sets a dangerous precedent. We need to able to trust health care professionals and, in my opinion, the focus should have been supporting the family emotionally rather than starting a ‘fight’ and ‘purple wave’. It costs hundreds and thousands of NHS money to keep this poor child ‘breathing’ and more in lawyers fees. You can’t keep brain dead people alive like a living shrine because you’ll be sad if they die. I so hope the court agrees with the original ruling and the family get the counselling and support they need.

I highly doubt they will win the appeal so I think your concern is silly. There have been similar cases in the past. It’s right that we have a diligent and rigorous court process to protect children/ families in this situation and make sure the decisions being made are the right ones.

They won't win. Cases like this are always granted permission to appeal and never succeed.

@Tandora you say it’s silly but as someone who see patients and has friends who work in ITU caring for patients in a similar position to Archie until care is gently withdrawn it would have a huge impact on their life and work.

As a HCP I absolutely agree, OP. However I doubt they will win. The medical evidence last time was very strong. Let's see what happens.

They won't win. They only got this appeal on a technicality, basically.

If we allow families to ‘choose'

That is not what is happening, and as an HCP you should have a far better understanding of the role of the courts when families and doctors do not agree.

It is entirely correct for this to be decided in court, and for any and all valid legal avenues to be used.

It just seems to me seeing his mum on the news that she is being given false hope x

I think its more about due process being seen to be done. They won't win. The people encouraging his parents to do this instead of helping them to accept the inevitable are absolute scum.

I feel for them so much, such an awful situation. YANBU

Caring for a patient like that would be traumatic for the staff although of course that’s not the point.

Actually I think it should be considered. Your job is to care for patients who are living. And If they're dying, to help them die as comfortably as possible.

This must go against all your training and ethics. I can't imagine how distressing it must be for the HCPs

I think it’s awful this family are being lead on by a group that just wants to win as a test case. They aren’t interested in this child or his family, they just want to preserve life at all costs.

it’s very hard for the family to accept what is happening when they are being manipulated.

Also, I know this is awful and I’m sure I would feel different if it was my child but when I see cases like this I always think of ITU beds as a finite resource. Sadly medical professionals often have difficult decisions to make on who gets an available bed, or to step people down to HDU before they should. You are right, we can’t keep people on life support indefinitely.

I understand your perspective, but as a lawyer, I think it’s crucial that where the courts make such a far reaching decision such as this, that they ensure due process is followed.

the Court of Appeal judges who have ordered the re-hearing of the case are extremely senior and intelligent. They haven’t given their full reasons yet but they wouldn’t do it lightly.

I fully expect the outcome will be the same - that life support can be brought to an end as sadly this poor lad can’t be saved. The evidence from medical experts about his prognosis will drive the court’s decision. The court won’t say that people can be kept alive on the family’s say so as a general principle, the court will say it is or isn’t in Archie’s best interests.

The people supporting this poor family will be coming for your reproductive choices any day now.

They have time and very deep pockets on their side.

I understood it to be on a technicality. The original finding was that he was brain stem dead, but that this can’t proved as the test they need to do, they were not able to. The next was “best interest” and this was not fully explored. The next hearing will explore this and will be unlikely to find that it is his best interests to continue the medical care.

I think the sticking point might be that the usual test for brain stem death is brain stem death testing, which the parents have refused permission for (unless I'm out of date). Therefore, the MRI scan has had to be used, which isn't typical. I wonder if the court can order that brain stem death tests are carried out, in which case there would be more evidence that there is no response to stimuli.

I think due process needs to be done. It's incredibly difficult for the parents but due process, although may give false hope, also gives them more time to accept and grieve, plus ultimately protects the healthcare providers that all avenues were explored and the parents, in their minds, went to the ends of the earth.

Such a sad, sad situation. My heart goes out to all

To be fair, having worked in ICU, the patient is the patient until they are away from your unit. I have cared for patients awaiting organ donation. They got just the same standard of care, turns, mouthcare, hair care, etc., despite being officially dead. There are many, many situations in ICUs where one Consultant will treat for longer than another would, and a nurse may feel conflicted about care continuing past what they feel is appropriate. At the end of the day, you just crack on and give the care that is needed.

Archie's mum has just won more time. That is it. The inevitable (his life support getting switched off) will still happen. His body might give out in that time anyway.
The poor lad is already dead. Prolonging this is distressing for his family and the staff caring for him.

I feel so sorry for the parents. I agree that it is utterly inhumane to give them false hope.

She hasn't accepted that though @XenoBitch although I absolutely agree with you.

It's so tough on all care providers involved, but it's her boy and for the rest of her life, has to live with his loss and "did I do everything, what if"

We all know looking from the outside in she needs to let him go.

I understand your perspective, but as a lawyer, I think it’s crucial that where the courts make such a far reaching decision such as this, that they ensure due process is followed

I think that in arguing a legal technicality they’ve forgotten common sense.

At the last case it was ascertained that Archie had not had blood supply to his brain since early April, that his brain was necrotising (rotting) and parts had dropped off into his spine. He was deemed dead by the previous judge from the end of May.

He fulfilled all but one of the conventional brain stem death criteria but one couldn’t be applied because he had no response from peripheral nerve testing. Essentially, he was just too dead.

I thought Wednesday’s hearing was supposed to be about that, but there now doesn’t seem to be any dissent that Archie is, in fact, brain dead.

The new issue to be discussed at appeal is whether it’s in Archie’s “best interests” to be ventilated still.

We’ve also learned that he can’t make anti-diuretic hormone, due to pituitary gland damage (death) so, if not medicated, will pass huge volumes of dilute urine. His fluid status and electrolytes require hourly calibration. He had 2 cardiac arrests a few weeks ago and was resuscitated.

So - the consensus is that he is dead. No one is waiting/hoping for a miracle cure. His body has high medical needs.

Why on earth is it necessary to have a court case to discuss whether it’s in the “best interests” of a dead body to be ventilated?

Thats it.There seems to be a lot of misleading headlines and confusion as to what today actually means. Seen a lot of comments on a article from Facebook people saying good how the family have won his support will stay on and now he can wake up and he'll recover when sadly...

It would absolutely break my heart to be in their situation.

I watched a documentary a few years (I think) back. Filmed in the U.S it took place in what they call a ‘vent farm’. Where patients are kept ventilated for years.It’s so rare anyone wakes up and if they do their quality of life is diminished. I doubt they’ll win and I hope they don’t, I just think it’ll prolong the pain. God forbid I ever be on the situation, but I hope I’d have the strength to agree to let go. It would utterly destroy me to lose my child. My heart goes out to them.

But it is really hard, when someone's heart is beating and their skin is pink, to understand that they are 'gone'. Someone with a neurological injury can look absolutely perfect when they're in their hospital bed. They just look like they're asleep. I can understand why the parents are finding it hard to accept that within the brain there is no life-sustaining function.