Family judges are extremely cautious before declaring that a patient is brain dead and authorising the termination of life-preserving treatment. A unique High Court case concerning a desperately ill baby boy who, against all expectations, resumed unassisted breathing showed precisely why such an approach is justified.
The three-month-old boy was taken to hospital after suffering a cardiac arrest. His circulation was interrupted for about 30 minutes. After being stabilised on life support, he exhibited no independent ability to breathe and a series of brain stem tests elicited no response. His condition prompted the NHS trust that bore responsibility for his care to apply for a judicial declaration that brain stem death had occurred and for permission to cease ventilation and medication.
All of that happened prior to extraordinary events that were unprecedented in the experience of all involved in the case. An extremely experienced nurse said that she had seen the boy moving and making attempts to breathe. Further tests showed that he was indeed breathing independently, albeit shallowly and irregularly. The diagnosis of brain stem death was immediately rescinded and the boy’s loving and attentive parents regarded what had occurred as a miracle.
The boy nevertheless remained in an extremely precarious condition and the Court acknowledged that it was in unfamiliar medical territory. Given the extent of that uncertainty, the Court adjourned the case to enable further expert evidence to be gathered. In the interim, he would remain on life support and attempts to resuscitate him would be made if he suffered a cardiac arrest. The possibility that he would be able to return home, even if only to die in the bosom of his family, could not be excluded.
His neurological status was deeply compromised, but the Court was satisfied that the manifestly outstanding care he was receiving continued to have a real objective and could not, at least at this stage, be properly characterised as futile. His parents, to whom faith was important, had given deeply moving evidence and the Court’s thoughts were with them and their son.