MEDICAL TREATMENT: NHS Trust v A [2007] EWHC 1696 (Fam)

27 JUL 2007

(Family Division; Holman J; 18 July 2007)

The seven month old child was suffering from a serious medical condition which would cause her to die within one year if she did not undergo a bone marrow transplant (BMT). A BMT would have a 50% chance of effecting a lasting cure so that she would have a normal life expectancy, with a 10% chance of her dying as a result of the treatment, a 10% chance she would survive but with a significant impairment, and a 30% chance that the treatment would be unsuccessful. The parents believed that the child should enjoy the quality of life she had left and not undergo the treatment. The child's guardian was very strongly in favour of BMT treatment. She should be given the chance of life rather than the certainty of death. The treating doctors sought an order that the BMT should go ahead.

The parents were well-educated, with a good understanding of the child's illness and BMT as a treatment. They were devoted to their children. The child had already received prolonged and severely painful treatment and the parents did not wish her to go through such suffering again. There was a high probability that the BMT would cause the child to be infertile in adult life, which distressed the parents greatly. They also strongly believed that God would cure her. They did not believe that, if treated, she would be in the 50% who would survive.

Where there was a dispute between parents and doctors over the treatment of a child the court must apply the relevant law, as summarised in ten propositions originally set out in An NHS Trust v MB [2007] EWHC 507 (Fam), [2006] 2 FLR 319. The religious views of the parents would not be taken into consideration. The only question was what was in the objective best interests of the child, with all relevant factors considered. The potential benefit to the child was the prospect of a full life. The pain and suffering that the child would endure as a result of the treatment, the risks that she would not survive or the treatment would not work, and the very high risk of infertility did not outweigh the 50% chance of a full and normal life, albeit infertile. The treating doctors were ordered to proceed with the BMT treatment.

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