In the latest in a long line of consistent and predictable cases, the UK High Court of Justice has ruled that clinicians may withdraw life-sustaining treatment for a child (T.R.) over his parents' objections.
T.R. has a serious, irreversible, and progressive brain injury. He no longer interacts with the world around him. The court ruled that T.R.'s "irreversible brain damage, the irreversible inability to breathe independently, the absence of cognitive awareness that will not be regained and the inability to experience pleasure) ... all weigh heavily in the balance against the benefits asserted by the parents in the continuation of the current regime of treatment."
The court considered "the parents’ strongly and genuinely held views against the withdrawal of treatment, the adverse impact on their right to family life with their only son, and the importance of their Islamic faith." But the court determined it is not in T.R.'s best interests for life-sustaining treatment to continue.
Interestingly the court relied heavily on "physiological burdens." Given his brain damage, it is unclear whether T.R. experiences discomfort or pain. Nevertheless, T.R.'s body will likely be burdened with a number of conditions:
- pneumonia
- worsening respiratory failure
- bone disease due to osteopenia (secondary to lack of load-bearing)
- associated pathological fractures and the development of renal stones
- scoliosis with associated cardio-respiratory impairment
- progressive gut failure
- seizures that become increasingly difficult to control
- a risk of infective complications and sepsis
These "physiological burdens" carried significant weight with the court in the best interests analysis even though T.R. has no awareness of them.
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