UK Judges to kill child...

[seer]

Go England!

UK judges double down on mandate to pull infant off life support, denies parents' appeal to take baby to Italy

The Italian government granted citizenship to Indi Gregory and the Vatican has offered continued treatment at a Catholic hospital in Rome

Judges in the United Kingdom have doubled-down on their mandate to remove a terminally ill infant from life support rather than allow parents to seek treatment at the Vatican.

Justice Robert Peel ruled Wednesday that 8-month-old Indi Gregory was to be removed from her life-supporting ventilator on Thursday against the parents' wishes. An appeal in the case has been denied and the child is mandated to be removed from life support imminently.

"Claire and I are again disgusted by another one-sided decision from the judges and the Trust. The whole world is watching and is shocked at how we have been treated," said father Dean Gregory, according to Christian Concern, their legal counsel for the case.

https://www.foxnews.com/world/uk-jud...ake-baby-italy

[Gondwanaland]

Go England!

They do seem to enjoy making sure children and teens die no matter what treatment they want to seek elsewhere...

[Sam]

The relevant ruling, including the patient's medical history and clinical prognosis:

Source: IN THE HIGH COURT OF JUSTICE FAMILY DIVISION IN THE MATTER OF THE INHERENT JURISDICTION IN THE MATTER OF INDI GREGORY (d.o.b. 24.02.2023)

The background

7. IG was known antenatally to have a hole between the two main chambers of her heart, as well as fluid in the brain. She was born in good condition, needing no resuscitation. She was almost immediately found to have a tetralogy of Fallot which is a combination of heart defects. She developed oxygen requirement and bilious vomiting, and was diagnosed with intestinal malrotation where the gut is not twisted correctly, for which she underwent a corrective surgical procedure. An MRI of her brain revealed congenital hydrocephalus, a build-up of fluid in the brain. A shunt was fitted. She went on to develop seizures. Further inquiries led to a diagnosis in June 2023 of Combined D-2, L-2 hydroxyglutaric aciduria, which is characterised by epileptic encephalopathy, respiratory insufficiency, abnormalities in the brain, developmental arrest, and early death.

8. After birth, frequent episodes of profound desaturation (that is to say, insufficient oxygen in the blood) and bradycardia (drop in heart rate) occurred and required bag mask ventilation for increasingly long periods of time, measured in hours. These took place sometimes several times a day (1-7 is referred to in the evidence). Until her recent deterioration, she on 8 occasions required PICU or NICU ventilation. On three occasions, she had cardiac arrests and needed CPR. No clinical way has been found to avoid these episodes. Recent therapies (medication, use of citrate and a ketogenic diet) have led to a reduction in the frequency of the desaturation episodes, but the overall prognosis is unchanged, and the plan is being implemented as a compassionate measure rather than in expectation that it will lead to improvement. She was last extubated on 31 August 2023, and a semi-permanent Hickman line was inserted.

9. She has challenging IV access, which is problematic in an intensive care setting where lines are required for life sustaining treatment. Apart from the Hickman line, other IV access has been required via needle insertion into veins. These processes, I am satisfied, cause pain and risk infection. On 10 occasions she has needed the drilling of a needle into her bones, often when awake, which again is a painful experience. She has a triple lumen line into her neck.

10. On 6 September 2023 she was once more intubated after a desaturation episode, and has been fully intubated and invasively ventilated since then. She has two nasal tubes, one for ventilation and one for feeding. Pain medication has increased; she is on eight medications for her comfort. She had further major episodes on or around 8 September and 25 September, each lasting 3 to 4 days, characterised by multiple desaturations and significant blood pressure support. She has fever spikes which are indicative (as I find) of brain deterioration, and are not markers of infections as the parents suggest. On 10 September 2023, and again on 7 October 2023, she required a blood transfusion. As outlined above, she had a diagnosis of central diabetes insipidus on 9 October 2023 when the matter was heard. A subsequent review of IG on 11 October 2023 confirmed that this was no longer present, but that her brain function was continuing to deteriorate. __

11. The parents’ suggestion that IG’s presentation (including the desaturation episodes) since the end of August is due to infection is not supported by the evidence. Other than E-Coli detected on one occasion on 28 August 2023, there has been no detection of any infection. Over the past few days, antibiotic treatment (which might have suppressed an infection) has been withdrawn and there are no markers of infection. Multiple tests have been carried out, including by a specialist microbiological team. I am satisfied that for over a month she has not had any infection which has caused or contributed to her presentation. __

12. She has been on full life support for about a month, critically ill and extremely unstable. She is intubated, ventilated, with multi-organ support, and sedated. She has the highest level of intensive care support and shows no sign of recovery. Her conditions are untreatable. It is of note that whereas her previous intubations lasted 3 to 4 days, this one has lasted a month, indicating the extent of her deterioration. Sadly, she is not, as the parents suggest, showing signs of improvement. There is no doubt in my mind that her presentation is on a rapid downward trajectory. She is now at the very limits of what is medically achievable for her.

...

ii) The medical evidence is extensive. There were three (now five) statements from IG’s lead consultant in paediatric critical care, a statement from a consultant in paediatric respiratory medicine, and a statement from a paediatric consultant with specialist interest in inherited metabolic disease; all are clinicians at the hospital where IG is an in-patient. In addition, there are exhibited statements or letters from the cardiology teams at two nearby hospitals. The Trust has also commissioned a second opinion from a paediatric intensivist at another hospital in the form of two letters which are before the court.

iii) The entirety of the medical evidence is unanimous. The medical evidence is that IG is now almost certainly permanently intubated. Her conditions are irreversible and untreatable. The current treatment causes IG pain, exposing her to harmful procedures and therapies which provide no long-term benefit. Life expectancy is severely limited and there are no curative therapies.

iv) There was no medical evidence to the contrary offered by the parents. They said that IG has an infection, but there was no evidence of that. All cultures were negative. In any event the parties agreed that IG would cease to receive antibiotics, and further tests over the following few days should establish the position definitively.

© Copyright Original Source

In short, the patient is terminally ill with no hope of even short-term improvement and continuing treatment is causing extensive suffering. While a hospital in Italy has agreed to accept the patient, there has not been any explanation of why continuing treatment will do anything but prolong the patient's suffering.

-Sam

[alaskazimm]

In short, the patient is terminally ill with no hope of even short-term improvement and continuing treatment is causing extensive suffering. While a hospital in Italy has agreed to accept the patient, there has not been any explanation of why continuing treatment will do anything but prolong the patient's suffering.

-Sam

Which is not up to a judge to decide, nor is it up to the doctors to decide.

[Sam]

Which is not up to a judge to decide, nor is it up to the doctors to decide.

Agreed — but I don't think you've considered the implications of that statement as it relates to this case.


Apologies; I misread. Yes, it is up to doctors to decide when medical interventions have been exhausted. It is not the absolute right of parents to pursue harmful or ineffective interventions that cause a child's suffering when such interventions have been conclusively shown to not be in the patient's best interest.

-Sam

[alaskazimm]

Agreed — but I don't think you've considered the implications of that statement as it relates to this case.


Apologies; I misread. Yes, it is up to doctors to decide when medical interventions have been exhausted. It is not the absolute right of parents to pursue harmful or ineffective interventions that cause a child's suffering when such interventions have been conclusively shown to not be in the patient's best interest.

-Sam

Indeed, but then the doctors are not in charge of the patients medical care; that is up to the patient or the caregivers. If one so desires, they can continue treatment even if it is not effective. By the same token they can refuse treatment (even if it is shown to be effective) and leave the hospital. It's not the doctor's or the judge's decision to withhold treatment or deny seeking treatment elsewhere.

[Sam]

Indeed, but then the doctors are not in charge of the patients medical care; that is up to the patient or the caregivers. If one so desires, they can continue treatment even if it is not effective. By the same token they can refuse treatment (even if it is shown to be effective) and leave the hospital. It's not the doctor's or the judge's decision to withhold treatment or deny seeking treatment elsewhere.

If the patient is an adult, this may be the case. In this situation, however, the best interests of patient may conflict with the desires of their caretaker. And parents do not have absolute authority over their children, such that they demand actions be taken that clearly harm the child with no substantial benefit. Conversely, parents cannot also deny necessary care with absolute authority.

The parents of this patient do not have any suggestion that her care has been less than exemplary or that her condition might even slightly improve or stabilize with interventional care in the near future. In their grief, they are demanding that their child be subjected to continuing harm and suffering for no plausible benefit. They do not have the absolute right to make that decision, which is where the ruling of a court of law becomes appropriate.

-Sam

[Mountain Man]

Thomas Jefferson wisely warned of the dangers of giving judges absolute power over questions of life and liberty:

"You seem to consider the judges as the ultimate arbiters of all constitutional questions; a very dangerous doctrine indeed, and one which would place us under the despotism of an oligarchy. Our judges are as honest as other men, and not more so. They have, with others, the same passions for party, for power, and the privilege of their corps...."

[rogue06]

The Death Panel has ruled. There is no appeal.

[Sam]

The Death Panel has ruled. There is no appeal.

Probably one of the reasons I find this kind of attitude so repugnant is because it's just utterly lazy. It's consistently uninformed, sure, but there's not even a principle at play among the crowd:

• Access to necessary medical care for children? No — apparent indifference to lack of childhood medical access.
• Wellbeing of the patient? No — persistently uninformed opinions unmoved by medical evidence.
• Parental control of children's medical interventions? No — actively opposed to medical interventions relating to gender-affirming care.

If people would take the time to read the important facts and make some actually relevant commentary, it'd be one thing. But it's just lazy snark for the purposes of self-indulgent entertainment ... which is normally a bit annoying. But this is about a terminal kid in considerable pain and grieving parents. People have a responsibility to approach that with more humanity.

-Sam

[Gondwanaland]

The Death Panel has ruled. There is no appeal.

Butbutbut death panels aren't a thing!!

[seer]

Butbutbut death panels aren't a thing!!

I think he is saying that these judges are effectively acting as a death panel...

[NorrinRadd]

I think he is saying that these judges are effectively acting as a death panel...

I think Gond's reply was mocking the frequent denials.

[Gondwanaland]

I think Gond's reply was mocking the frequent denials.

Indeed.

[JimL]

Go England!

The baby apparently has little hope of survival, but I don't get the courts decision at all. If the parents want to bring the baby to Italy and Italy and the Vatican have already agreed what in blazes could be the objection UK's Healthcare system and the courts. This story makes no sense at all, unless there's more to it than is made clear in this story. Makes no sense!!