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.

Mn keep saying its because its an ongoing court case but so was charlie gard and all those threads stood

mn wont answer the question

Why @NotYetAnotherUsername are you asking NW to hide this thread and for MN to delete it? This is a judicial case so presumably public interest in discussing the legal/medical arguments. Plus there is already an active social media involving the case on FB and others so why mount an argument to delete this thread rather than request deletion of individual posts that may cross TG?

I may have misunderstood but I thought they were appealing the way they defined his death?

That was what Wednesday’s appeal process was supposed to be about, Archie had all but one of the brain stem death tests performed but couldn’t have the last one. The last one needs a peripheral nerve response and he has none (cos dead) but technically that could give a false result.

So the medical team performed imaging and brain flow studies, showing that there had been no blood flow to his brain since April and that part of his brain had dropped into his spine and that his brain images were that normally seen in dead people. The High Court deemed that was sufficient and declared him dead.

Archie’s team tried to appeal on a number of points and were allowed the right to appeal on the basis that he hadn’t had that final brain stem test and whether imaging/blood flow could be sufficient.

But - instead of arguing that point yesterday (I’m in Australia) there was a swerve to whether the High Court had adequately considered Archie’s “best interests” and that seems to be what the new appeal has been granted on, not the medical details.

In the press, there’s some conflation between what Wednesday’s appeal was about (brain stem death) and what the new appeal was granted for (Archie’s best interests) but the BBC report clearly states that the hearing in July is just about his “best interests”.

I agree with MNHQ - it's not appropriate. Posts may be seen by the family too. They don't need criticism and speculation by posters on Mumsnet to add to their woes.

yet here you are....posting on the very thread you are whinging about! boosting it to the top of active as well....

When someone you love is killed outright or dies of a disease ,that's it,they are gone. They look dead very quickly. The essence of that person is gone. The relatives have no choice but to face it, and all the utter agony that goes with it. If someone is on machines that make them look 'alive' it's a totally different situation. You can sit there and watch their chest go up and down and convince yourself that it's a temporary nightmare and, one day soon, they will open their eyes and things will improve. Its easy for people on the outside to see that he is gone. The machines are keeping his body functioning to a degree but its just a shell. Any parent would cling to anything for it not to be over. At least , if they fight at every stage, then one day they may be able to find peace with it. None of us can judge.

yeah yeah....you are only here to cause trouble to try and get the thread deleted that way

move along now....

then why not the other cases that were disscused

Well, they did win the appeal. The question now is what will be the outcome of the remitted High Court hearing that has been ordered as a result.

We've moved some way on from this. The judge gave permission for the final brain stem death test to be used, but ultimately it couldn't be because he failed a preliminary peripheral nerve test which means that the test itself could throw up a false negative. Hence the use of the MRI scan. Unfortunately the Court of Appeal today didn't consider the issue of whether he is dead, because they took the view that the judge should first have considered the issue of best interests and she had failed to do so.

People are having a measured, civil discussion about this and I can’t really believe a grown adult has gone and tattled to try and get it shut down.

Did you mean to be so rude @PansyPetunia ? Yes

I've been on Mumsnet since dinosaurs roamed, so I won't be bothered or bullied by the likes of you.

I've given my opinion as have you and now I'll leave it up to MNHQ and Night Watch to decide and keep an eye on. Many posts on the deleted thread were just awful. At least some on here need to go already, IMHO.

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.

I don't think this is correct, as Archie's family certainly don't accept this. In essence that issue seems to have been put to one side. The Court of Appeal allowed them to argue some further grounds of appeal, but indicated pretty firmly at the outset that what they were interested in was whether the judge should have considered best interests before considering whether Archie had died; and that in focussing on the latter issue, she had effectively closed out the former. So the rest of the hearing essentially focussed on that. I'm really not sure where that leaves us in relation to the standard of proof for brain stem death, but maybe they will clarify that in their written decision.

It's also not correct that the hearing will focus on what Archie's wishes might have been. It's a factor they will take into account, but the point the Trust's lawyer made today was that he was only just 12 at the time of the accident, and although he may have expressed some sort of view in one context, no-one believed that he had sufficient understanding of all the possibilities and what is involved to be able to express a conclusive view.

I think this introduces important ethical issues.

Archie’s brain is necrotic and falling down his spine, there has had no blood flow to his brain for months and he is unresponsive and his body has high levels of medical need.

If the appeal is successful and it is deemed in his “best interests” to stay ventilated indefinitely because of his religious beliefs and something he reportedly said to his brother when he was alive this has massive implications for end of life care in general.

especially because his fluid balance is so precarious - he requires PICU level nursing care, not just someone to manage the ventilator.

It opens the door for a cultural shift in how dead people are managed.

They tried, but to be able to administer the test reliably the patient has to pass a peripheral nerve test first, otherwise the test result isn't reliable - and Archie didn't.

And I really can't believe that grown adults want to discuss this tragic child for their entertainment and are certainly no help to the child and his devastated family. 'Tattled'? - are you 13, Spencerfloral?

The Court of Appeal has found that the High Court's best interests assessment is indeed appealable, because the judge didn't really go into that issue as she was concentrating on the brain death question. So the new hearing will be expected to focus on best interests, and it will go way beyond what Archie might have wanted.

I'm really not sure where that leaves us in relation to the standard of proof for brain stem death, but maybe they will clarify that in their written decision

That’s what I don’t understand - they won an appeal to talk about brain stem death and didn't talk about it but earned the right to appeal about a separate issue?

There’s not a logical, step wise process where Archie’s “best interests” declaration need to be settled before he can claim to be dead.

You are asking for blind faith in the NHS, I think it is quite easy to find out why that is an unreasonable expectation to have, especially in such an emotive situation.

because the judge didn't really go into that issue as she was concentrating on the brain death question

She did though, that’s the odd part. She didn’t delve into the religious significance though, I don’t think. Just acknowledged that he wore a cross and was interested in Christianity through his MMA.

The Court of Appeal opened by saying that they had given permission on, I thin, five further appeal grounds, and indicated pretty firmly that in their view the judge should have considered best interests before considering brain death. So no-one really had to argue the brain death point at all - I have the impression that they're saying that, had the judge decided it wasn't in his best interests for ventilation to be continued, then she didn't need to consider whether he was brain dead at all.

and it will go way beyond what Archie might have wanted.

so on that basis it may equally,
fall short of what Archie might have wanted
or,
it might meet his exact wishes

No, the last one hasn't been deleted. It has been reinstated, and wasn't deleted for that reason anyway.

So the new hearing will be expected to focus on best interests, and it will go way beyond what Archie might have wanted.

This is the crux of it really, and I think the aim of the Christian legal group. To legally redone death

I have the impression that they're saying that, had the judge decided it wasn't in his best interests for ventilation to be continued, then she didn't need to consider whether he was brain dead at all.

I wonder if she thought that the opposite applies - if someone is dead they can’t have best interests (other than their body being treated with respect)?