Friday, October 08, 2004

Judge Tells Parents Their Baby Must Die

Severely ill baby ought to be allowed to die, judge tells parents
By Maxine Frith, Social Affairs Correspondent
08 October 2004

Darren and Debbie Wyatt sat in a wooden pew at the Royal Courts of Justice, gripping each other's hands, barely able to look at the judge as he ruled that, despite their most fervent wishes, their 11-month-old daughter should be allowed to die.
Making the ruling, Mr Justice Hedley said: "As a society we fight shy of pondering on death, yet inherent in each of us is a deep desire, both for oneself and for those we love, for a 'good' death. It would be absurd to try to describe that concept more fully beyond saying that everyone in this case knows what it means ­ not under anaesthetic, not in the course of painful and futile treatment, but peacefully in the arms of those who love her most."
As he finished reading his judgment, and the lawyers stood to begin discussing costs, Mr and Mrs Wyatt remained sitting, in tears, seemingly unaware of life moving on around them. Seventy miles away, in a windowless hospital room, Charlotte clung to life by the thinnest of threads, as her fate was determined in case law, philosophical argument about the quality of life and complex medical evidence.
Yesterday's ruling means that the next time Charlotte succumbs to yet another infection and stops breathing, she will not be resuscitated. Instead, she will be taken from the box which pumps oxygen to her starved brain and allowed, in Mr Justice Hedley's ruling, "to die peacefully in her parents' arms".
Mr and Mrs Wyatt had fought the doctors at St Mary's Hospital in Portsmouth all the way to the High Court over their claim that Charlotte's life was so intolerable she should be allowed to die if she stops breathing. The devout Christians said their daughter was a "fighter" and should be revived at all costs. Yesterday afternoon, the fight seemed to go out of them.
They had said they would take the case all the way to the European Court of Human Rights, but now their solicitor said they have no intention to appeal against the ruling.
Mrs Wyatt, 23, who is heavily pregnant with the couple's third child, stroked her stomach as her husband put his arm around her when it became apparent the judge was going to rule in the doctors' favour. Even the judge, used to difficult cases involving families and children, said he felt "a little uncomfortable" in his position as final arbiter of Charlotte's life and now almost certain death. "I'm being asked to override the wishes of these parents as to what is best for their daughter," he said.
But in the end, the judge said, all the medical evidence indicated that Charlotte was profoundly mentally and physically disabled with no hope of recovery and "a terrible quality of life". He added: "I do not believe any further aggressive treatment, even if necessary to prolong life, is in her best interests.
"I know that may mean she may die earlier than otherwise she might have done, but in my judgment the moment of her death will only be slightly advanced." He said Charlotte should be able to "meet her end whenever that may be in what Mr Wyatt called the TLC of those who love her most".
Charlotte was born by Caesarean section last October when her mother was 26 weeks pregnant. On a ventilator for the first three months, Charlotte still weighs only the equivalent of a three-month-old. She cannot see or hear, has no control over her movements and has the most extreme form of cerebral palsy. She also suffers from chronic lung disease and cannot breathe without an oxygen box over her head.
In the past five months, Charlotte has stopped breathing three times and doctors say she is in constant pain with "no joy or fulfilment". She will never be able to sit up or take food by mouth. After her last collapse in July, doctors at the hospital asked her parents for their consent not to revive her if she stops breathing again. They say that each time she is resuscitated, she suffers further damage and pain and that to revive her would be "futile and even cruel". Mr and Mrs Wyatt refused to give permission, saying their Christian faith meant they believed in the preservation of life "at all costs".
The hospital took the case to the High Court for a ruling that it could override the parents' wishes in Charlotte's best interests. Courts have had to rule in similar cases, but the Wyatt case was unique because it was heard in open court.
The judge said the case involved the "fundamental principles of the sanctity of human life" and the concept of what constituted a bearable standard of living. He said: "In reaching my view, I have of course been informed by the medical evidence as to the prospects to her of aggressive treatment. I hope I have looked much wider than that and seen not just a physical being but the body, mind and spirit expressed in a human personality of unique worth who is profoundly precious to her parents."
During the two-day hearing, eight paediatric experts had agreed that Charlotte's life was "intolerable". Even the specialist called by the Wyatts' lawyer said that the only reason to reventilate Charlotte would be to give her parents more time to come to terms with her inevitable death.
Even the most optimistic of doctors said she had only a 25 per cent chance of surviving for another year even if she were resuscitated. Most experts put that at less than 1 per cent.
Yet Mr and Mrs Wyatt insisted Charlotte recognised them, could grip their fingers and derived some comfort from being held by them. Mr Wyatt told the judge: "I believe there are things in medical science to help her carry on, even for a couple of years, and she could even go outside and see the trees and whatever."
Last night, they made the journey back to their daughter's hospital room and their 20-month-old son Daniel. Doctors believe that with the onset of colder weather, Charlotte will develop an infection within weeks, and stop breathing.