Archie Battersbee - Thread 3

[BongoJim]

Follow on from previous full thread

www.mumsnet.com/talk/in_the_news/4596573-archie-battersebee-case-thread-2?page=1

Yes I recall the folks involved in suggesting to me that my Mother be switched off, and explaining to me that they thought she'd go fairly quickly but she might hang on a few hours, were quite surprised when I asked some questions and had around 20 minutes to think and make calls, and then agreed that yes, better now than later.

They were lovely - could they have flowered it up and taken longer and fetched me more tea and fannied around.. I am sure they could.

But they were patient and kind, explained things clearly and let me know that ultimately it was THEIR decision that switch off was the best thing to do, and my thoughts were taken into account... rather than it being my choice and my responsibility.

They were also busy people with other things to do (and this was A&E on a Saturday night) and that was obvious to me but no one pointed it out or rushed me, I had time to talk to my best friend and my partner, ring my Dad and sister and let them know (and stop them rushing to be with her as it would have done neither of them any good).

Some of the clarity in the descriptions of what would happen if this, if that - they were fairly blunt and graphic 'if you do x there will be gasping and gurgling and twitching...' 'if you do Y then this will happen', but I don't see a way round that, you can't NOT tell people what will happen then leave them to find out when it happens.

They do often take a long time, but they can move quickly if they have to.

Alfie Evans' parents went twice to the ECHR. The first time there was an actual point of law to clarify and it took 8 days. The second time the application to the court was refused within 3 days.

Even 8 days is a long time though in this case. It was ruled that even 1 day was not in Archie’s best interests. Doctors have already said that his organs are failing, so it’s actually possible that his heart will stop beating before the ECHR can rule, and the CLC know that.

Sadly they’ve played a blinder. They are contemptible bastards. All of them. Using someone’s personal tragedy to further their own agenda.

Okay that makes sense.

Terrible analogy again, It's a bit like if you want to test an engine but the only way to do that is turn the ignition but when you do nothing happens. It could be the engine is broke but it could also be the ignition is broke (I don't understand cars).

So my understanding is in this case there is a lot of evidence without the test. The test itself is obviously designed to operate in a window. Everybody who would require this test would necessarily already be in a professional medical setting and, understandably, there wouldn't usually be a delay in administering it. It was designed to be given as soon as appropriate.

I think I understand it now.

They could have gone to the ECHR instead of attempting to go to the UN. (But no earlier, for the reasons you say.)

It is assumed that they went to the UN instead on the chance that it might work, given that the ECHR is unlikely to rule in their favour.

I disagree that they can only now issue a Human rights application. They exhausted all legal means after the Hayden Judgement was upheld by the CoA but before the UN application. They issued the UN application because the ECHR application looks so shaky given the previous decisions in Gard and Evans.

@Miffee I think the car analogy is a very good one. And if the wires between ignition and engine have rusted away then turning the key will tell you literally nothing about the state of the engine. Because the signals just aren't getting through.

So stage one is to test if the wires are working. In Archie's case, sadly, they aren't, because of how very unwell he is.

Okay so this explains it a bit but I am still confused. If the preliminary test couldn't be done wouldn't that be an answer in itself?

No, because it creates doubt.

The peripheral nerve tests isn’t actually required, but one of the preliminary tests. It’s indicated if there are concerns that the sedation or paralysing agents commonly used to intubate or maintain intimation are still on board. Hollie actually latched onto this early - they wanted to do this day 3 or so but she maintained that he was still sedated.

the motor test is withdrawal to pain, the peripheral nerve test doesn’t Look for movement, it checks that there is an electrical impulse when a nerve is stimulated with an electrode.

Peripheral motor nerves communicate with muscles and enable them to move. If the peripheral nerves are damaged the muscles can’t move. If you severed the motor nerve in your thumb you would want it to move, but it won’t. You can imagine a scenario where someone is paralysed but aware but can’t move because they are paralysed, not because their brain isn’t working

I don’t know whether it’s routine for this hospital to do this test first, or whether they did because of the scrutiny. The “rules” are to do if you think someone still might be under the influence of sedating/paralysing drugs, so 5 half loves (not long).

In reality, when they actually did it, Archie’s brain was rotting, liquid, dropping off etc so it’s part of a wider clinical picture.

In practice, sometimes not all of the brain stem tests are able to be done with patients but the ancillary tests are down frequently such as MRIs, EEGs, blood flow tests and generally families just accept what they are shown.

A pp posted something from a neonatologist saying the test was invalidated because Archie had a spinal injury, but, depending on the level of the lesion, there should still be a peripheral nerve response above the lesion. Plus, Archie didnt have a spinal cord injury. That was scanned for on admission. His spine rotted, but later when his brain was rotting.

Moral of the story is that if they felt like they needed to do this test first, they waited too long

I cannot get over how inappropriate it is to be even discussing moving Archie to a Hospice. It can't and won't happen.

It would be of no benefit to Archie and as previous posters have already said, the sad likelihood is that he would die during transportation. No doubt accompanied by lurid accusations about the staff accompanying him.

It would be no benefit to his parents and family and it is beyond cruel to allow them to believe it could happen.

The circus surrounding Archie would have a huge impact on other children attending the hospice and their families. Imagine how frightening it would be for a chijd attending therapy or a sibling attending family support. And imagine how other parents grieving would be affected.

And no, it shouldn't happen after death either. Appropriate arrangements can be made through the hospital mortuary or the undertakers chapel of rest.

Can anyone link the Dignity For All page - I keep getting the LGBT page
TIA

@OpinionsUnseen I thought they could have approached the EHCR last week but instead chose to go via the UN route. So threw in a four/five day delaying process.

Be that as it may. Fact is that they’ve bought themselves a huge amount of time with this. Likely long enough for life support to not have to be withdrawn.

I suppose that if we have to see something positive in this, at least it will remove the use of the emotive language such as murder and execution etc if Archie dies “naturally”.

it would have been wrong to inflict Archie and the circus on a hospice. Completely unfair on the others there.

plus, with his fluid issues he’s too unstable. He’ll die very quickly.

So if this latest appeal is unsuccessful can they go anywhere else or is that the end?

Put Archie after it in FB search and you'll find it. The logo is a purple heart on a black background

I'm presuming then that they will file with ECHR in the morning, and a stay will be put in place until such time that they respond. Which could be months going by their backlog.

What a shit show.

It's been confirmed by the Christian group that they are submitting it.. Just seems madness now. I know she wants time and is finding it hard but someone needs to say enough is enough. In her interview she said she knew what today's outcome was most likely to be

Well I can't say I'm surprised the people in that group don't have a job to go to on Friday morning or anything else better to do than harass a hospital.

Is it true his brain is necrotic? Is this what you mean by liquid? If so how is that phrased in the rulings?

Also what is the issue with his urine? I have heard a lot about it but understand the divine significance beyond things not working as they should. Would the issues with urine and his digestion (which I understand) occur in any other conditions?

Sorry for bombarding you with questions but I have read all the court rulings and just get frustrated at not understanding the medical stuff.

That did say don't understand the significance not "understand the divine significance"

The urine issue is to do with his pituitary gland not working.

Therefore he cannot control his body's fluid outlet and the vasopressin is balancing this.

He has various infusions to replace bodily functions the brain itself would do because it can't do it itself any longer.

Basically your brain is a computer. Your muscles are more like a printer. And the nerves are the wires. In order to complete the tests you have to prove the order to print is able to get through the wires and the printer can print, but the computer isn’t telling it to. So the muscles could move if they were commanded to by the brain. So you need to test the all components separately - that the computer works, the wires are connected and um damaged and the printer works. I’ve no experience of this test specifically, but I’m fairly sure they do things like a withdrawal response to a painful stimulus. But you need to prove the wires haven’t been sliced though, or someone could be completely brain-alive, but still unable to move and ‘pass’ the tests. So they do electronic nerve conditions tests to make sure the nerves are intact and that a nerve stimulus could pass all the way along. Reportedly, it was this that couldn’t be done by the time the courts ordered it, I think. I don’t know why (and I can’t see why unless I’m muddling it with something else). It’s doesn’t actually matter, as the courts set aside the issue of whether or not he was ‘legally dead’ or brain stem dead or whatever, and judged that it was not in his best interests to continue treatment. Best interests is how these cases usually go, and should go, anyway. What’s best for Archie is the only thing that matters.

It would not be uncommon in an injury like Archie’s to have a neck fracture, and be paralysed as well as the oxygen deprivation, so it’s really important to be sure that no muscle response is because of brain stem impairment, not spinal cord or peripheral nerve impairment (which are survivable, but could also produce the appearance of impaired brain stem function on the tests in an unconscious person if not tested independently)

There's a condition called diabetes insipidis which does the same thing (essentially) and it's nothing to actually do with diabetes and blood sugar.

Thank you.

There are no other courts beyond ECHR.

There are, theoretically, new things that the High Court might be forced to rule on. For example whether Archie can be moved?