The NHS Trust v A (a child) & Ors, Court of Appeal - Family Division, July 18, 2007, [2007] EWHC 1696 (Fam)

Extract

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The NHS Trust v A (a child) & Ors, Court of Appeal - Family Division, July 18, 2007, [2007] EWHC 1696 (Fam)

Neutral Citation Number: [2007] EWHC 1696 (Fam)

Case No: FD07P01051

IN THE HIGH COURT OF JUSTICE

FAMILY DIVISION

Royal Courts of Justice

Strand, London, WC2A 2LL

Date: 18/07/2007

Before:

MR JUSTICE HOLMAN

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Between:

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Huw Lloyd (instructed by Weightmans) for the applicants

Miss Melanie Carew (instructed by CAFCASS) for the first respondent child

Philip Havers QC and Sydney Chawatama (instructed by Leigh Day and Co)

for the second and third respondent parents

(counsel and solicitors instructed and acting pro bono)

Hearing dates: 4th, 5th and 9th July 2007

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Judgment

Mr Justice Holman:

The issue

1. A baby known as A is nearly 7 months old. Currently she is well (although taking controlling drugs) and lives happily at home in a loving, caring and devoted family. But it is medically certain that she suffers from haemophagocytic lymphohistiocytosis (HLH). She has already been very ill, and without treatment it is medically certain that she will die, and probable that she will die by about the age of one, or within another year or so from now at the very most. The only effective treatment is a bone marrow transplant (BMT). In the circumstances of this case, the doctors estimate that such a transplant has about a 50 per cent prospect of effecting a lasting cure so she then has a normal life expectancy. There is also about a 10 per cent prospect that she will die during and as a direct result of the treatment; a 30 per cent prospect that the treatment will not be successful and she will still die from her underlying HLH; and a 10 per cent prospect that although she survives she may have some significant impairment. The treatment will be lengthy, painful and distressing, and could be very painful indeed. A's parents believe that she should enjoy the quality of such life as remains to her and not undergo the treatment. The doctors strongly disagree and have asked the court, in place of the parents, to give the necessary permission or consent for the treatment to take place.

2. There is an unusual feature to the case which I should make clear at the outset. Usually when contested medical issues of this kind arise, the child concerned is already in hospital and undergoing some treatment. The question is then whether a particular form of treatment should or should not be given or continued. In this case, as I have already said, baby A is currently at home and well. She would only arrive at the hospital for the BMT if her parents take her there and, in practice, their active participation and co-operation would be required before and during the treatment. There has been no suggestion whatsoever in this case that the court should positively order the parents to take...

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