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.

Why can’t they do the tests that they didn’t want doing in the first place to confirm for sure he’s brain dead. I mean I agree that it seems highly likely he is, but the judges ruling that he was probably brain dead didn’t sound convincing to the parents. But I know they are disputing the tests, as they don’t want to face the sad truth that there’s no recovery from this. My heart goes out to them.

That isn’t my understanding, but that’s because they only had permission to appeal on the standard of proof ground. However I don’t think the court of appeal’s judgment is available yet, or if it is, I haven’t been able to find and read it. So we will have to wait and see what they think the high court needs to reconsider specifically. I’d be very surprised if they’ve decided to remit it just for the fuck of it in case someone brain dead should be kept alive indefinitely, but they might have made a stupid decision in this individual case - courts do sometimes! However the high court’s assessment of best interests was excellent and I don’t think appealable per se - possibly the assessment of best interests needs to be done once it is decided if Archie being brain dead is proved to the higher standard. But we will see.

the thing is that it is all very well saying it’s “farcical” to have a court case on this but by what mechanism do you say cases such as this should be prevented?

(although whether the declaration that Archie is dead has been proved to the relevant standard is under challenge so as things stand he hasn’t been proven brain dead legally. I do agree having read the evidence that it is likely to be proved to that standard at the next hearing).

The problem was that the first judgement didn't say strongly enough that the boy was brain dead

That was supposed to be what was discussed on Wednesday’s hearings - whether someone who couldn’t have all the conventional brain stem death tests (Archie had all but one, and one couldn’t be carried out as he had no peripheral nerve response because he’s dead) could be declared brain stem dead on the basis of imaging, blood flow (or lack of).

I was only listening to it in patches but that didn’t seem to be in dispute anymore🤷‍♀️

The new argument is that all of the previous arguments about whether he was brain stem dead mean that Archie’s best interests haven’t yet been properly considered. And that is what July’s court case is about.

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

initially, i agree. But she’s had 3 months to come to terms with this, to listen to the dr’s and courts that are telling her her son is dead.

i am getting angrier by the day that she is putting that poor child’s body through this circus, including releasing some pretty awful photos of him that no 12 year old would ever want anyone to see.

I don't think this is a case that can be won, the implications and the precedent it would set would be enormous.

At present, you can choose to refuse any treatment advised by medics, as long as you have capacity, have someone with a POA for health and welfare, or have made an advance directive/living will.

However, you cannot do the opposite: you cannot request to receive a treatment against medical advice.

This case would be effectively overturning the current situation, and the floodgates of requests for treatments that are unnecessary/unwarranted/unproven would absolutely sink the NHS.

I didn’t realise the details of his brain - seems very clear, though I do agree with due process as a principle.
It does concern me the ‘Christian’ charity support - though I’m not sure how they balance medical prolonged life with God given life - still what really bothers me is all the ‘work’ around cases like these at start and end of life and less bother about the middle bit with alive and kicking people needing help. I think faith can provide comfort and support in these times for some people and it’s a shame they couldn’t stick to that.

I couldn’t ever judge a parents thinking/decision making in this situation. It must be absolutely horrific & they have my deepest sympathies. Worst nightmare.

That isn’t my understanding, but that’s because they only had permission to appeal on the standard of proof ground

They were given leave to appeal on the specific issue of whether brain stem death could be made by imaging, which is fair, because it’s new. That’s what I thought it would be about but then their barrister didn't seem to challenge or dispute the brain death issue at all. I was interested in this (cos medic) and I was wondering if it would expand the criteria for brain death tests. MR angiograms are newer than conventional brain stem tests.

The point of contention now seems to be best interests because Archie’s team say it wasn’t given sufficient consideration in the High Court judgment, of only a few paragraphs

the thing is that it is all very well saying it’s “farcical” to have a court case on this but by what mechanism do you say cases such as this should be prevented?

I don’t think there needs to be a court case to clarify whether it’s in the “best interests” for someone who has been deemed legally dead, where the medical details are no longer in dispute or debated, to be ventilated indefinitely.

Permission was definitely given as to balance of probabilities vs beyond reasonable doubt for proof of brain stem death, but that may not be the focus of the court of appeal’s reasons when they come out. Arbuthnot J only discussed best interests as an alternative decision, as it wasn’t strictly necessary given her decision to declare Archie brain dead, but even still I think it was detailed and sensitive and if that is the basis on which the appeal has been successful, I am surprised. That said, if that’s the decision of the court, I still believe in the importance of due process even if I don’t agree with the court’s decision.

Regardless, I don’t think the outcome will be as OP fears, that family’s are given the right to insist treatment continues indefinitely. Even if it happens in Archie’s case (which is unlikely), it would be specific to him and not of wider application. That issue of principle isn’t on the table so I don’t think OP need worry.

I think it’s right that the parents have the right to appeal. If the evidence is as clear as it seems they won’t win but I wouldn’t want to live in a country where doctors could end my child’s life without my right to be heard in court.
Obviously it is always, always better for families and medical professionals to come to an agreement. But where that can’t happen there needs to be external oversight.

someone who has been deemed legally dead

the legal basis of that declaration is being challenged.

The “best interests” argument is driven by the Christian group as well, with Archie’s faith one of the reasons his team is arguing he should stay ventilated.

From the High Court judgment the family’s faith has consolidated since Archie has been in hospital.

the legal basis of that declaration is being challenged

Then why didn’t the barrister address it on Wednesday? Why is it now all about “best interests”?

Legally, there absolutely does and there should. Where medics and families disagree, it’s only fair and right that a judge makes the decision. If we say this one doesn’t need a BI decision made in court, we risk starting a slippery slope.

YABU to start another thread about Archie when the last one about him was deleted by MNHQ - not in the spirit and about a tragic situation a distraught mother and family are going through right now, whatever your theoretical opinion or mine.

Archie was the only religious one in the family until recently when the family started praying for him on FB weekly.

His mum’s torment must be all the worse cos Archie accidentally killed himself (hanged himself with a dressing gown cord).

Of course she needs hope to stay sane, who could think of a more extraordinarily bleak event.

Where medics and families disagree, it’s only fair and right that a judge makes the decision

They’ve had their court hearing about this though and it was ruled by the High Court that he was dead.

Then Wednesday’s hearing was granted on the basis of brain death testing and how accurate imaging and blood flow testing was in Archie’s specific situation where there was no response to peripheral nerve tests (too dead).

However, it swerved away from arguments about the medical details and into whether Archie’s “best interests” had been considered. Which seems to be wht the appeal has been granted for, not the medical details.

The “best interests” argument is driven by the Christian group as well, with Archie’s faith one of the reasons his team is arguing he should stay ventilated

what I don’t get about these christian groups and their life at all costs thing, is the contradictory ideas around heaven being a better place and all that.

if “god called him home”, why are they keeping him trapped in that hell on earth instead of letting his soul rest in peace.

why fight so hard to keep him here when the whole principle of christianity is our reward is in heaven…

My thread was deleted on this but i'll comment again while i can

its not good she stood outside court and said she was right and the doctors are disgusting to try and stop treatment for him

shes not letting go at all

I think she's receiving very poor guidance from her family and friends and that Christian organisation. She seems to shun any support she's offered from the hospital in favour of her online echo chamber. But her family should really be supporting her through her grief - they should be supporting each other - not egging each other on.

I may have misunderstood but I thought they were appealing the way they defined his death? If Archie is deemed not brain dead - and clearly he is not able to make any decisions as he would lack capacity - then a best interests decision should be made.

Why should the thread be deleted? The mother herself posts on SM. We are all mums, we have empathy. It's a relevant discussion because god forbid, this isn't the first case, or will be the last.