Key Facts
- •Indi Gregory (IG), born February 24, 2023, suffers from combined D-2, L-2 hydroxyglutaric aciduria, severe ventriculomegaly, and tetralogy of Fallot.
- •IG is on a paediatric intensive care unit with a very limited life expectancy and experiences significant pain and distress from multiple invasive procedures.
- •Nottingham University Hospitals NHS Foundation Trust applied for declarations that it is not in IG's best interests to receive various life-sustaining treatments.
- •IG's parents oppose the application, believing that she shows signs of improvement and has a right to all possible treatment.
- •The Children's Guardian supports the Trust's application.
- •Extensive medical evidence unanimously supports the Trust's position that continued treatment is futile and causes IG significant pain.
Legal Principles
Paramount consideration is the best interests of the child, considering medical, emotional, sensory, and instinctive factors.
Manchester University NHS Foundation Trust v Fixsler and others [2021] EWHC 1426
There is a strong presumption in favor of preserving life, but it is not absolute and can be outweighed by suffering and lack of quality of life.
Aintree University Hospital NHS Foundation Trust v James [2013] UKSC 67
The court must form its own view on the child's best interests, considering the views of doctors and parents but not bound by them.
Manchester University NHS Foundation Trust v Fixsler and others [2021] EWHC 1426
The court considers human rights (Articles 2, 8, and 14 of the ECHR), but UN conventions are not directly applicable in UK law.
Dance v Barts Health NHS Trust [2022] EWCA Civ 1106; R (on the application of SC, CB and 8 children) v Secretary of State for Work and Pensions and others [2021] UKSC 26
Expert evidence is only necessary if indispensable, not merely useful or desirable.
Re: H L (A Child) [2013] EWCA Civ 655
Outcomes
The court granted the Trust's application.
The burdens of invasive treatment outweigh the benefits due to IG's incurable condition, very short life expectancy, lack of quality of life, and significant pain experienced during treatment.