Judge rules not to resuscitate baby despite some improvement
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《英国医生杂志》
The parents of Charlotte Wyatt, a 15 month old brain damaged baby at the centre of a battle over treatment to prolong her life, failed last week in their attempt to persuade a High Court judge to lift his earlier order authorising doctors not to ventilate her if her condition worsens.
Darren and Debbie Wyatt had asked Mr Justice Hedley to suspend the order pending a hearing before Easter in which they hope to persuade him to lift it altogether on the grounds that her condition has greatly improved.
Mr Justice Hedley made his order in October last year after hearing that Charlotte had serious brain, lung, and kidney damage, was blind and deaf, was fed through a tube, needed a constant supply of oxygen, and was incapable of voluntary movement or response.
David Wolfe, counsel for the parents, argued that as the judge had authorised further medical reports for the forthcoming hearing, he should observe the presumption in favour of preserving life and lift the order. Otherwise Charlotte, who weighed less than 500g when she was born three months prematurely, could die before the case was heard.
David Lock, for Portsmouth Hospitals NHS Trust, which has cared for her since birth, told the judge that the improvements were due to the medical care she was receiving but that her underlying condition was unaffected.
The judge said he was "delighted" by the improvements observed in Charlotte since he made the order but that there was no evidence to show that the improvements reflected any change in Charlotte抯 very serious underlying condition.
He had seen a report from a consultant paediatric neurologist that said: "She now generally has good days whereas some months ago she seemed to be in a state of distress and discomfort requiring regular medical sedation which was no longer needed."
Her need for oxygen had declined, and she could be taken out of her head box and held and cuddled while wearing a face mask to deliver oxygen. She reacted to loud noises and would frown and grimace, but this did not point to any change in her underlying condition. She had grown very little and her brain not at all, the judge said. Orders should not be varied without clear grounds for doing so.
Richard Stein, solicitor for the Wyatts, said the parents were considering whether to go to the Court of Appeal.
A spokesman for the trust said, "The trust is grateful to the judge for the sympathetic and humane way in which he dealt with this very difficult case once again."
"We are also pleased he recognised that the high standard of care is producing benefits for Charlotte, but the underlying very serious condition is unchanged," he added.(BMJ Clare Dyerlegal correspondent)
Darren and Debbie Wyatt had asked Mr Justice Hedley to suspend the order pending a hearing before Easter in which they hope to persuade him to lift it altogether on the grounds that her condition has greatly improved.
Mr Justice Hedley made his order in October last year after hearing that Charlotte had serious brain, lung, and kidney damage, was blind and deaf, was fed through a tube, needed a constant supply of oxygen, and was incapable of voluntary movement or response.
David Wolfe, counsel for the parents, argued that as the judge had authorised further medical reports for the forthcoming hearing, he should observe the presumption in favour of preserving life and lift the order. Otherwise Charlotte, who weighed less than 500g when she was born three months prematurely, could die before the case was heard.
David Lock, for Portsmouth Hospitals NHS Trust, which has cared for her since birth, told the judge that the improvements were due to the medical care she was receiving but that her underlying condition was unaffected.
The judge said he was "delighted" by the improvements observed in Charlotte since he made the order but that there was no evidence to show that the improvements reflected any change in Charlotte抯 very serious underlying condition.
He had seen a report from a consultant paediatric neurologist that said: "She now generally has good days whereas some months ago she seemed to be in a state of distress and discomfort requiring regular medical sedation which was no longer needed."
Her need for oxygen had declined, and she could be taken out of her head box and held and cuddled while wearing a face mask to deliver oxygen. She reacted to loud noises and would frown and grimace, but this did not point to any change in her underlying condition. She had grown very little and her brain not at all, the judge said. Orders should not be varied without clear grounds for doing so.
Richard Stein, solicitor for the Wyatts, said the parents were considering whether to go to the Court of Appeal.
A spokesman for the trust said, "The trust is grateful to the judge for the sympathetic and humane way in which he dealt with this very difficult case once again."
"We are also pleased he recognised that the high standard of care is producing benefits for Charlotte, but the underlying very serious condition is unchanged," he added.(BMJ Clare Dyerlegal correspondent)