An NHS Foundation Trust v Kwame & Ors
[2023] EWHC 134 (Fam)
Alder Hey Children's NHS Foundation Trust v D & Ors
30 June 2023
[2023] EWHC 1997 (Fam)
High Court
A very sick 14-year-old boy needs a machine to breathe. Doctors say he's unlikely to get better and is in a lot of pain. His family disagrees on what's best, but the judge decided, after listening to doctors and considering the boy's suffering, that it's kinder to let him go. The judge made sure he would be comfortable and surrounded by his loved ones at the end.
Key Facts
- •14-year-old C requires life-sustaining treatment (ventilation) due to severe illness (Steven-Johnson Syndrome and Critical Illness Polyneuropathy).
- •C's condition shows minimal improvement over 14 months.
- •The Trust applied to discontinue life-sustaining treatment, supported by C's mother and guardian, opposed by the father.
- •Independent expert evidence from pediatric critical care and neurology consultants was obtained.
- •Experts concluded that continuing life-sustaining treatment is not in C's best interests.
- •C experienced a life-threatening sepsis episode during the proceedings.
- •C's pain is a key consideration, though managed to some extent.
Legal Principles
Best interests of the child are paramount.
Children Act 1989
Presumption in favour of preserving life, but not irrebuttable.
Case law (implied)
Assessment of benefits and burdens of continued treatment.
Case law (e.g., Pippa Knight)
Article 2 (right to life) and Article 8 (right to family life) of the European Convention on Human Rights.
ECHR
Outcomes
Declaration that it is lawful and in C's best interests to withdraw mechanical ventilation.
The burdens of C's illness and treatment outweigh the benefits, given the lack of prospect for meaningful recovery. The experts' unanimous opinion supports this.
Declaration that C should receive palliative care.
To ensure a comfortable and peaceful end-of-life experience.
Defined limits on treatment after ventilation withdrawal.
To allow C to die peacefully.
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