Alfie Evans has a ‘relentless and progressive’ neurological condition
The parents of brain-damaged Alfie Evans have lost their bid to overturn a ruling that doctors can switch off their son’s life support.
A High Court judge has ruled that doctors can stop treating Alfie, 21 months, against the wishes of his parents Kate James and Tom Evans.
Three Court of Appeal judges upheld that decision on Tuesday.
Judges have heard that Alfie, who was born on May 9 2016, is in a ‘semi-vegetative state’ and has a degenerative neurological condition doctors had not definitively diagnosed.
Mr Justice Hayden had analysed the case at hearings in the Family Division of the High Court in London and Liverpool.
Specialists at Alder Hey Children’s Hospital in Liverpool said life-support treatment could stop and the judge said he accepted medical evidence which showed that further treatment was futile.
Alfie’s parents Tom Evans, 21, and Kate James, 20, challenged Mr Justice Hayden’s ruling and asked the Court of Appeal to consider the case.
They were not at the appeal hearing in London today but listened via a telephone link from Liverpool.
Lord Justice McFarlane, Lord Justice McCombe and Lady Justice King, who had examined issues at a Court of Appeal hearing in London on Thursday, dismissed the couple’s challenge.
Mrs Justice King said Alfie’s parents were ‘unable to accept what movements in Alfie they see are not positive responses’.
Mrs Justice King said medical evidence showed that Alfie was ‘deeply comatose’ and ‘to all intents and purposes unaware of his surroundings’.
Lady Justice King said: ‘I think, in fairness to the parents waiting anxiously on the other end of the telephone line, I should tell them immediately their applications for permission to appeal are refused.’
His parents had argued he should be taken abroad to continue the search for a diagnosis and cure.
Alfie’s parents Tom Evans, 21, and Kate James, 20, claim their son has been ‘sentenced to the death penalty’
Specialists at Alder Hey Children’s Hospital in Liverpool said continuing to provide life-support treatment was ‘unkind, unfair and inhumane’ and have asked judges to rule that life-support treatment could stop
Kate James and Tom Evans, parents of 21 month old Alfie Evans, arrive at the High Court, London, on February 20
They said the Bambino Gesu Hospital in Rome, Italy was willing to take him in.
The Italian hospital had proposed carrying out two surgical procedures, one placing a breathing tube into his throat and another placing a feeding tube into his stomach.
Barrister Stephen Knafler QC, who is leading Alfie’s parents’ legal team, said ‘the State’ had wrongly interfered with ‘parental choice’.
Alfie’s parents had argued he should be taken abroad to continue the search for a diagnosis and cure
He said Alfie’s parents wanted to move him to the hospital in Italy but Mr Justice Hayden’s ruling had prevented them from doing that.
Barrister Stephen Knafler QC, who is leading Alfie’s parents’ legal team, said ‘the State’ had wrongly interfered with ‘parental choice’.
He said Alfie’s parents wanted to move him to a hospital in Europe but Mr Justice Hayden’s ruling had prevented them from doing that.
Earlier, Mr Justice Hayden said Matthias Hubner, who is based in Munich, Germany, had fallen below expected professional standards.
The judge said Dr Hubner had gone to the Alder Hey Hospital in a ‘clandestine manner’ – posing as a ‘friend of the family’ – claimed to have seen all of Alfie’s files when he had not, and produced a ‘travel plan’ containing an inappropriate ‘medical regime’.
‘Dr Hubner gave evidence and was cross-examined,’ said Mr Justice Hayden in his ruling on Alfie’s case.
‘He accepted that he had gone to the Alder Hey Hospital in a clandestine manner, posing as a friend of the family.
‘He agreed… that he had deliberately withheld his professional status from the doctors and staff.
‘He told me that he had never done that before. I am at least relieved to hear that.’
At the Family Division of the High Court in London, Mr Justice Hayden said Matthias Hubner, who is based in Munich, Germany, had fallen below expected professional standards
The judge said Dr Hubner had made an ‘assertion’ that he had ‘seen all of Alfie’s files’.
‘He accepted in evidence that this was not the case,’ said Mr Justice Hayden.
‘In fact, he has seen very little.’
The judge added: ‘Perhaps most alarmingly, Dr Hubner’s travel plan for Alfie set out an anticonvulsant medical regime which, on the basis of Alder Hey’s experience with Alfie, would have been ineffective and inappropriate.’
He went on: ‘I am at a loss to know quite why Dr Hubner fell so far below the standards expected of his profession. I am constrained to say that he has failed the parents, the court but most importantly, Alfie.’
Mr Justice Hayden also complained about another medical expert Alfie’s parents had asked to ‘assist them’ using ‘inflammatory’ language in a report.
The judge suggested that Professor Nikolaus Haas, who is also based in Munich, had used the case as a ‘platform’ for his own beliefs.
He highlighted a paragraph in Professor Haas’s report, which read: ‘Because of our history in Germany, we’ve learned that there are some things you just don’t do with severely handicapped children.
‘A society must be prepared to look after these severely handicapped children and not decide that life support has to be withdrawn against the will of the parents if there is uncertainty of the feelings of the child, as in this case.’
Mr Justice Hayden said it was ‘inappropriate’.
‘Professor Haas was instructed by these parents to assist them and the court on the basis of his experience and expertise, which is evidently considerable,’ said the judge in his ruling.
‘It is no part of his function however to utilise the case as a platform for his own personal beliefs.
‘I found the… paragraph to be inflammatory and inappropriate, not least because the views expressed bear no relationship to and do not engage with the facts of this case.’
A video released by Alfie’s aunt appears to show him responding to his mother
Ahead of a Court of Appeal hearing, Alfie’s aunt Sarah Evans posted videos of the 21-month-old in his hospital bed, labelling him a ‘truly special miracle’.
In the clips she claims he is responsive to his mother’s touch and is able to suck a dummy and chew her finger.
Sarah Evans also claimed Alfie is able to move his stomach muscles as she said she was ‘praying for justice’.
Last week a High Court judge ruled that doctors can stop treating Alfie, against the wishes of his parents.
Mr Justice Hayden, who analysed the case at hearings in the Family Division of the High Court in London and Liverpool, said he accepted medical evidence which showed further treatment was futile.
Alfie’s parents challenged Mr Justice Hayden’s ruling and asked the Court of Appeal to consider the case.
Three appeal judges began analysing issues at a hearing in London on Thursday.
TIMELINE OF SERIOUSLY ILL ALFIE EVANS WHOSE PARENTS ARE BATTLING THE NHS TO KEEP HIM ALIVE
Last week a High Court judge ruled that doctors can stop treating Alfie, against the wishes of his parents
May 2016: Alfie Evans is born apparently perfectly healthy, but misses numerous developmental milestones in his first seven months
December 2016: Alfie catches a chest infection causing seizures, and is taken to Alder Hey Children’s Hospital in Liverpool where he is put on life support. He has been there ever since
July 2017: Father Tom Evans says he is seeking US treatment for his son and hopes Charlie Gard’s supporters will help after he claimed doctors want to turn off Alfie’s life support.
December 17: Alfie’s parents say they will begin mediation with the hospital in a bid to find a way forward without legal action
December 19: Mr Evans claims the toddler is letting them know he wants to live
February 1: The case goes to the High Court in Liverpool, where the hospital reveal the parents smuggled a German doctor into hospital in a bid to stop the life support from being switched off
February 2: Consultant tells High Court that the child is unresponsive, not conscious of his surroundings and cannot be cured
February 5: Parents are told by doctors there is ‘no hope for recovery’ for their boy who has suffered ‘catastrophic degradation’ to his brain from a ‘relentless’ condition
February 7: Miss James tells a newspaper that she feels ‘physical’ pain at the thought of her son’s death
February 20: Mr Justice Hayden rules that doctors can stop providing treatment to Alfie.
February 22: Alfie’s father, Tom, 21, said he would appeal against the decision, saying ‘doctors should take a step back.’
March 1: Three appeal judges began analysing issues at a hearing in London.
March 6: Court of Appeal hearing tomorrow will decide on whether doctors can stop Alfie’s treatment.
Alfie’s parents, who believe that the little boy responds to them, wanted treatment to continue. His father is pictured here arriving at the Royal Courts of Justice
Barrister Stephen Knafler QC, who is leading Alfie’s parents’ legal team, told the appeal that he wanted to raise ‘various points of law’.
Alfie’s parents, who believe that he responds to them, want treatment to continue and hope to fly their son to the Vatican-linked Bambino Gesu Paediatric Hospital in Rome for treatment.
If that proved unsuccessful they hoped he could be taken for treatment in Hamburg before eventually being permitted to die at home.
Alfie’s neurological condition is so rare that doctors have never seen it before. One even suggested it may eventually be named ‘Alfie’s Disease’.
Alder Hey NHS Foundation Trust said in a statement: ‘Today the Court of Appeal upheld the judgement from the High Court that continued active treatment is not in Alfie’s best interest.
‘We understand that this is a very difficult time for Alfie’s family and we will continue to work with them to agree the most appropriate palliative care plan for Alfie.’