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.

@nolongersurprised

I didn't realise all that. So I'll change my stance as that is enough medical information to let the boy go.

@Clymene you are right. We had a similar case in my units PICU. The child had fined but parents were refusing brain stem testing. The staff looking after her, really really struggled and found it unbearable. The small crumb of comfort that they could have had by donating her organs was lost as well, as it was too late.

An appeal is almost always granted they will lose. The mum while grieving has taken her anger and pain out on the staff calling them a euthanasia squad and accusing them of starving him.
I feel immensely for the staff I don't think I could work in those conditions no doctor or nurse wants to switch off a 12 years old life support they do it because it's in his best interests. He has already died.

@DarkDarkNight I agree I've been looking after a patient who's surgery was delayed for a week as there was no picu bed.

I can understand why the parents are finding it hard to accept that within the brain there is no life-sustaining function

It’s been nearly 3 months though, of no signs of life. I find this macabre. We have rituals/customs around managing the dead and ventilating a corpse isn’t culturally acceptable.

Archie’s mother has been shown his brain scans, and refused to believe they were his.

I feel so much for his poor parents and family who are going through this. Also agree that they're being given false hope, which is ultimately unhelpful. I work with families of patients who are in a comatose state and being assessed as to whether they should continue to receive ongoing treatment to prolong life. When I heard Archie's mum say her evidence that he was still 'in there ' was that she had once felt his hand move my heart sank. Anyone who works with patients like Archie will know that there can be many reasons for limbs to move/twitch/grasp and sadly it is not always indicative of meaningful (conscious) movement. It doesn't make it any easier or less heartbreaking for families to hear this though.

Exactly this. We should be afraid, because their version of our future is terrifying

His mum has been despicable. Saying the staff are "slaughtering" her son, that they have been "starving" him, that the ward has a "death chamber". She praises the staff on one hand, and accuses them of murder on another.
Those exhausted staff have been treating her son like his is still alive and will be walking out at some point, for her. They put up a sign with his name on above his bed, and she gushed about it on one article, and said the staff were neglecting him on another.

They are going back to court to decide Archie’s best interests. They haven’t won just delayed the inevitable. I can’t see anyone deciding it would be right to keep a child with no blood flow to his brain on a ventilator indefinitely. It’s hard as they mum says his heart is still beating, yet it is only beating due to the machines.

the judge said today he was taken really poorly before the last court date and the resuscitation team needed to be called. He may not even make it to the next hearing sadly but at least he will be at peace.

Firstly, it’s necessary to have a court case because due process is a vital safeguard in our society. Maybe in Archie’s case the outcome is easy to predict, but we live in a democracy which upholds the rule of law, and safeguards people’s rights. Are you suggesting parents should never have the right to challenge the decision of a doctor that their child should be allowed to die? Because that’s the logical consequence of what you’re saying. It’s all very well saying in this case the outcome is obvious but who makes the decision as to which cases are clear cut and which cases are arguable? The court.

Secondly, a “technicality” is slightly underplaying it. I believe the issue is the standard of proof. The High Court decided it was likely Archie is brain dead. The question is whether that is a high enough standard of proof, or whether the court needs to decide the evidence shows he is brain dead beyond reasonable doubt. That’s actually a very important distinction.

I agree the outcome is likely to be the same, but we have a process for deciding these important decisions fairly and thoroughly through the courts. The implications of this decision are massive for Archie and his family. The process must be followed, and we can’t just do away with it because people think the outcome is obvious. That really would have consequences for our society, if due process could be disregarded as and where people thought it wasn’t necessary.

If I was working there , I would refuse to even speak to her without another witness there. I know she's grieving but she has accused the staff who are only trying to care for him of the most awful things.

My only thought on this is that it would be terribly sad if this little boy were to die while his family were sat in a courtroom. Being there at the end is what he needs.

His mum has behaved absolutely disgracefully towards the staff. Grieving or not, she's crossed a line to being downright abusive to them and encouraging it from others.
She has to accept he died months ago, he's not going to wake up. The right to appeal is just going to delay the inevitable a little bit longer.

Are you suggesting parents should never have the right to challenge the decision of a doctor that their child should be allowed to die?

But he has already been deemed legally dead, at the previous court case.

I thought the upcoming new case was just to argue whether or not it was in his best interests to have ventilation stopped, not to dispute the medical findings/consensus. The medical issues were presented at the court case a few weeks ago and the judge declared him dead, they’ve had their due process on that issue.

The most recent court case was supposed to be about whether he could be declared brain dead without the last test. This couldn’t be performed because he had no response to peripheral nerve testing (too dead) so the court a few weeks ago was shown the scans of his necrotic brain. The appeal for Wednesday’s hearing was won to discuss whether this was considered “enough” but somehow didn’t seem to actually be in dispute?

My understanding is that the next court cause will be centred around what Archie would have wanted, given that he supposedly previously had a conversation with his brother about this scenario and how his new found faith fits into stopping ventilation. Not around the medical details

My second baby was stillborn, and I was induced. Even though I knew he was already dead and scans had shown no sign of life, when he came out all warm and looking as if he should breathe any moment, my gut instinct was to beg the midwife to try rescuscitation on him. It was primal. So I get that his parents aren't accepting that their son is already dead...

But the fact that the family are using legal routes to artificially keep him alive doesn't sit comfortably with me at all. I feel horribly sorry for the medical team that are having to keep up with such invasive and frankly cruel treatment.

Shouldn't think the judge and the lawyers are enjoying the case much, but they’re not complaining. Neither are Archie’s doctors. They’re making the hard decisions.

Nurses don’t like end of life care - as any hospice will tell you - but they get to move on to other patients every 20 min. And none of the responsibility that causes the most pain.

What exactly do you mean by this? Plenty of nurses give excellent end of life care. Nurses work in hospices and give the majority of personal care, are palliative care specialists etc. I think it’s very unfair to say nurses ‘don’t like’ end of life care. We accept it as a vital and important part of our role and it can be incredibly fulfilling to do it right.

It’s shit.

the poor child is dead, and the family really need to accept it. It’s a hard decision, but it’s coming up to 3 months, he isn’t going to wake up. I don’t think the echo chamber of that facebook group is helping either.

what I find incredibly sad is the one bit of good, that could have given Archies family comfort in the coming years- organ donation, is now gone.

The problem was that the first judgement didn't say strongly enough that the boy was brain dead. It said 'possibly brain dead', which made the family think the judgement wasn't definite.

Which is why nurses are so hard to hire and keep in hospices…

And yes, I think it’s farcical to have a court case solely to decide whether it’s in the best interests for someone who has been declared dead (legally) to remain on a ventilator.

Especially when their brains are so rotting they have dropped down into their spinal cord.

It's a horrific situation for his family and for the HCPs looking after him. I think his family, specifically his poor mum, are holding onto hope that isn't there and they're doing what is right for them not him.

Reminds me of Charlie Gard's family ...

His mum has been despicable. Saying the staff are "slaughtering" her son, that they have been "starving" him, that the ward has a "death chamber". She praises the staff on one hand, and accuses them of murder on another.
Those exhausted staff have been treating her son like his is still alive and will be walking out at some point, for her. They put up a sign with his name on above his bed, and she gushed about it on one article, and said the staff were neglecting him on another.

Intense grief, disbelief and the feeling of utter powerlessness can make people aggressive, angry and irrational. We all hope we would be calm and accepting and reasonable in extremis, but at this time I can't feel anger towards Archie's mum.

I couldn't agree more with this, now I know more since being on this thread. I was for the due process but I understand CLC are behind this as well....