(If you want to read this report at the site, click yes when it asks if you are in the medical profession) Ed Madden, BL, looks at a recent English High Court case in which the court was asked to approve the administration of blood products to a baby boy whose parents were Jehovah’s Witnesses and who would not consent on religious grounds. Awas born at the University Hospital Coventry and Warwickshire on February 7, 2014. On the following day it was noted that his saturations had fallen to 77 per cent. He was transferred to the special care baby unit, where an echocardiogram was undertaken. This confirmed a diagnosis of transposition of the great arteries or other complex heart disease, together with restrictive septum. In the late evening of February 8, 2014, he was transferred to the paediatric intensive care unit at Birmingham Children’s Hospital. Further tests were undertaken which confirmed the earlier diagnosis. On February 9, 2014, a septostomy was performed in an attempt to improve the baby’s oxygen levels while he awaited a cardiac operation. That procedure was successful. It was decided that the child should undergo an arterial switch operation and related procedures on February 14, 2014. A’s parents were Jehovah’s Witnesses. While they consented to their child undergoing cardiac surgery they would not, because of their religious beliefs, consent to him receiving blood products either during the course of that surgery or subsequently. The Birmingham Children’s NHS Trust brought an application in the High Court in which it sought a number of orders, including an order that it would be lawful and in A’s best interests that he undergo urgent heart surgery to switch his great arteries. This would require that his blood be passed through a heart bypass machine and that a blood transfusion be administered. When the matter came on for hearing on February 13, 2014, the court was told that the parents did not wish to attend the hearing because they did not want to make the proceedings any more complex than was necessary. In the course of an email to the court they stated that they understood that the judge might well overrule their objections and order the surgery to take place with the necessary blood transfusions. They would not actively try to prevent their son’s treatment and they would not actively oppose the application made by the Trust. A consultant paediatric cardiologist at Birmingham Children’s Hospital gave evidence that if the operation was not undertaken, the baby had no long-term prospect of survival. He might not die immediately but he was unlikely to live “beyond babyhood”. The risk of him not surviving the operation was about 2 per cent and the risk of damage to other organs during the course of the surgery was of the order of 3-5 per cent. Proposed procedure The consultant said that it was simply not possible to perform the surgery without using blood products. Were the child to suffer the loss of some blood following surgery, that blood would need to be replaced. He said that if the proposed procedure was carried out successfully, the prospects of the child leading a normal life were excellent. Giving his judgment in the case, Mr Justice Keehan said that in reaching a decision on the application made by the Trust, he had to consider A’s best interests in the widest possible sense. While there were risks attached to him undergoing the operation, those were “minimal risks”. Starkly, on the other hand, if he did not undergo the operation, his chances of survival were extremely poor. The judge said he noted and gave great weight to the fact that the parents consented to their child undergoing the surgery. They understood and accepted that if their child was to survive “there was no choice”. Their objection to the use of blood products was on the basis of their religious beliefs. The judge understood and sympathised with their stance. They deserved enormous credit for the fact that, notwithstanding their strongly held beliefs, they did not wish to actively oppose the application made by the Trust. For perfectly understandable reasons, they did not wish to participate in the court hearing. They had helpfully provided mobile telephone numbers to the court in the event that the judge wished to speak to them. That would not be necessary. Mr Justice Keehan said he had no doubt whatsoever that it was in A’s best interests to undergo the surgery. Notwithstanding the parents’ understandable objections on religious grounds, it was also in the child’s best interests to receive blood products both during the surgery and, if necessary, subsequent to the operation. The court went on to make the orders sought by the Trust. Reference: [2014] EWHC 531 (Fam) imt.ie/opinion/2014/03/court-rules-in-best-interests-of-baby-over-religious-beliefs.html
Posted on: Thu, 20 Mar 2014 17:50:22 +0000
Trending Topics
Recently Viewed Topics
© 2015