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Alfie Evans’ mother strokes his face in touching video after judge rejects parents’ appeal

The father of Alfie Evans said his family has ‘sustained his life for the third time’ as the toddler continues to cling to life two days after his life support was withdrawn. 

Alfie’s mother, Kate James, posted footage of herself stroking her son’s face at Alder Hey Hospital, Liverpool, where doctors removed his ventilator on Monday night. 

She wrote on Facebook: ‘My whole entire world I love you so much baby boy.’ 

It came after the 23-month-old’s parents lost their latest appeal to have their terminally ill son transferred to Italy for treatment yesterday. 

She wrote on Facebook: 'My whole entire world I love you so much baby boy.'

Alfie’s mother, Kate James, posted footage of herself stroking her son’s face at Alder Hey Hospital, Liverpool, where doctors removed his ventilator on Monday night

This picture of Alfie and his father sleeping in the background was posted on Facebook

This picture of Alfie and his father sleeping in the background was posted on Facebook

Supporters shared this photo of mother Kate James cradling her son at Alder Hey Hospital in Liverpool, where doctors have withdrawn life support. He is still alive two days later

Supporters shared this photo of mother Kate James cradling her son at Alder Hey Hospital in Liverpool, where doctors have withdrawn life support. He is still alive two days later

Q&A: Can Alfie be saved?

Can doctors end Alfie’s life against his parents’ wishes?

Alder Hey Hospital took Alfie’s case to the High Court and a judge agreed to allow them to end his treatment because it was not in his best interests.

The Court of Appeal, the Supreme Court and the European Court of Human Rights all rejected appeals by his parents, who believe they should have the final say on their son’s treatment.  

Can the doctors change their mind and not turn off his life support?

Yes. Alder Hey could go back to the High Court to stop the order they fought for this year – but it is highly unlikely.

The process of gaining a Consent Order could be done on an urgent basis and completed in less than two hours.

Experts have told MailOnline this is the only way he could travel to Rome for treatment.

Can the hospital stop his parents taking him out of the country without permission?

Yes. If doctors believe that any parent will cause suffering to their child, police can be called in to arrest them using Powers of Protection legislation.

In the case of young cancer sufferer Ashya King his parents faced a European Arrest Warrant after absconding with their son who was in hospital.

Alfie has been on a ventilator so would require a team of medical staff to move him and his equipment. 

If parents still refuse to accept treatment should be withdrawn, can the hospital end it anyway?

Yes. Police could be called in to facilitate treatment being ended if parents were violently preventing it – although it is highly unlikely this would happen. Doctors are more likely to try to ‘persuade’ parents to let it happen.

If the parties remain at loggerheads for a long period the hospital could go back to court for an injunction and ask a judge to set a deadline for treatment to be withdrawn. 

Friends were seen bringing ventilation equipment and a defibrillator to the hospital following calls from Alfie’s aunt Sara on Facebook yesterday. 

It is unlikely relatives would be able to use such equipment on Alfie, who suffers from a degenerative neurological condition, as to do so would be in breach of a court order.    

Saying Alfie had needed his life sustaining three times, Mr Evans said: ‘He’s comfortable, content, fighting – the three words I’ve used all the way through this case. He’s more comfortable now he’s got no tube and he’s breathing for himself.

‘I don’t want to be big-headed and say, “I told you so”, but we had to fight hard against this to say, “Remove the drugs, remove the machine”, and he’s doing it now.

‘He ain’t showing no sign of suffering or that he needs support or anything. The nurses have been coming in to review him and they’re happy.

‘He looks comfortable. He looks chilled. And that’s the most important thing right now.’  

Supporters keeping vigil outside the hospital tonight were told Mr Evans had ‘fallen asleep next to his little boy’ and would not be speaking again until Thursday morning. 

The Bambino Gesu paediatric hospital in Rome, which is administered by the Vatican, has said a specially-equipped plane is on standby to fly to Britain to pick up Evans if he is released. 

Tom Evans met the pope in the Vatican last Wednesday after several statements of support made by the pontiff. 

It emerged at yesterday’s Court of Appeal hearing that the toddler’s father wants three Alder Hey Children’s Hospital doctors prosecuted for conspiracy to murder. The medics who cannot be named, have each been served with a summons, the court heard. 

Alfie’s parents, Tom Evans and Kate James, who are now represented by different legal teams, were defeated again in their bid to have Alfie transferred to hospital in Rome, where the Italian government has granted him citizenship. 

At a hastily arranged appeal hearing in London yesterday afternoon, Paul Diamond of the Christian Legal Centre – who is representing Mr Evans – asked judges Lord Justice McFarlane, Lord Justice Coulson and Lady Justice King to let Alfie be flown to Rome for treatment. 

The barrister said that there had been a ‘significant change of circumstances’ as Alfie was still breathing despite being taken off a ventilator at 9.40pm on Monday. Jason Coppel QC, representing Miss James, also claimed that as a European citizen Alfie ought to be allowed to fly to Italy. 

Supporters outside the hospital last night where staff say they have been feeling intimidated

Supporters outside the hospital last night where staff say they have been feeling intimidated

Supporters tie balloons outside Alder Hey Children's Hospital, Liverpool, yesterday evening

Supporters tie balloons outside Alder Hey Children’s Hospital, Liverpool, yesterday evening

A supporter of Alfie Evans's parents is pictured crying after hearing the appeal had been rejected last night with supporters outside Alder Hey Children's Hospital

A supporter of Alfie Evans’s parents is pictured crying after hearing the appeal had been rejected last night with supporters outside Alder Hey Children’s Hospital

Supporters of Alfie Evans's parents are pictured gathering outside the hospital yesterday

Supporters of Alfie Evans’s parents are pictured gathering outside the hospital yesterday

Police remained in place outside as they revealed they were monitoring social media posts

Police remained in place outside as they revealed they were monitoring social media posts

Merseyside Police say they are monitoring social media posts 

Police in Liverpool have said they are monitoring social media posts relating to Alfie Evans in a bid to stop ‘malicious’ messages. 

They warned that any threatening posts could prompt police action as tensions remain high outside the hospital and amid the ongoing legal battle.

Chief Inspector Chris Gibson said: ‘Merseyside Police has been made aware of a number of social media posts which have been made with reference to Alder Hey Hospital and the ongoing situation involving Alfie Evans.

‘I would like to make people aware that these posts are being monitored and remind social media users that any offences including malicious communications and threatening behaviour will be investigated and where necessary will be acted upon.’ 

But the judges rejected both lawyers’ claims, agreeing with the hospital that nothing had changed since a High Court judge first ruled in February that it was not in Alfie’s best interests to leave Alder Hey.

They said the fact that the child was breathing unaided did not mean he was improving because doctors had never suggested death would be instantaneous, and that in reality he was dying.  

Alfie’s father said yesterday there is no longer a dialogue between them and the doctors, who they say have not tested or observed their son since his life-support machines were withdrawn at 9pm on Monday. 

Mr Evans’s barrister, Paul Diamond, said an air ambulance was on standby at the ‘request of the Pope’. Its German pilots were thrown out of Alder Hey yesterday afternoon.    

Mr Diamond argued that there had been a ‘significant change of circumstances’ because the life-support treatment had stopped, but Alfie was still breathing. The hospital’s lawyers submitted that Alfie’s death had never been expected to be ‘instantaneous’. 

The lawyer, who is counsel for the pro-life group the Christian Legal Centre, also said there were ‘tensions’, but insisted that there was no ‘hostility’ against the NHS.

But, in an astonishingly frank exchange, Lord Justice McFarlane responded by telling him: ‘Your client purported to take out a private prosecution to have three named doctors charged with the criminal offence of conspiracy to murder.

‘Those summonses were served on the doctors and I hear you say that there is no hostility to the NHS.’ 

Mr Diamond replied: ‘There is no hostility but within that process there are tensions.’

Jason Coppel QC said Alfie’s mother Kate James had told him: ‘Alfie is struggling and needs immediate intervention.’

The judges heard that Ms James is now represented by Jason Coppel QC rather than Mr Diamond who continues to represent Alfie’s father.

Mr Diamond said Alfie could be ‘kept prisoner’ in hospital ‘when there is alternative, fantastic care available for him, telling the judges: ‘We submit there is a likelihood of Alfie having some pleasure in life. That is beyond our knowledge.’

Lady Justice King said: ‘That is not the evidence. The evidence is that he is unlikely to have pain, but that tragically everything that would allow him to have some appreciation of life, or even the mere touch of his mother, has been destroyed irrevocably.’ 

Alder Hey’s doctors, nurses and staff say they have faced vitriol from some of the toddler’s supporters, making it ‘impossible’ for the little boy to go home, the High Court heard yesterday. 

The family of terminally ill toddler Alfie Evans have released pictures of the little boy clinging to life in his mother Kate's arms

The family of terminally ill toddler Alfie Evans have released pictures of the little boy clinging to life in his mother Kate’s arms

Supporters keep vigil for Alfie Evans outside Alder Hey Children's Hospital last night

Supporters keep vigil for Alfie Evans outside Alder Hey Children’s Hospital last night

Alfie Evans: Timeline of court cases brought by parents against Alder Hey Children’s Hospital

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 

February 1 2018: The case goes to the High Court, 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 20: Mr Justice Hayden rules that doctors can stop providing treatment to Alfie. 

March 6: Three Court of Appeal judges back High Court judge’s ruling that that doctors can stop treating Alfie.

March 20: A panel of three justices, headed by Supreme Court president Lady Hale, decide that the case is not worth arguing and has refuse to give the couple ‘permission’ to mount a further appeal.

April 11: High Court judge endorses an end-of-life care plan for the 23-month-old boy.

April 16: Parents mount new legal challenge, asking that he be allowed to travel, but again lose at the Court of Appeal. Alfie’s parents apologise after reports of intimidation and verbal abuse among hospital protesters. 

April 20: Supreme Court rejects latest legal bid for the youngster to travel.

April 23: European Court of Human Rights refuses to intervene. The Italian Foreign Ministry grants Alfie citizenship amid protests outside the Liverpool hospital. 

April 24: Special session of High Court in Manchester rejects application to overturn decision

April 25:  Appeal judges asked to overturn April 24 decision. The parents’ appeal is denied

In an open letter, chairman of Alder Hey hospital Sir David Henshaw and chief executive Louise Shepherd said staff had been ‘deeply affected’ by the story of Alfie Evans and felt ‘deeply’ for him and his whole family.

But they defended staff from what they said had been a ‘barrage’ of abuse.

The letter said: ‘Yet in the last two weeks we have found ourselves at the centre of a social media storm that has included many untrue statements about our work and the motivations of our staff.

‘This has led to often inappropriate interventions from a range of external bodies and individuals, some of which have caused significant disruption to our children, families and staff. 

‘Our nursing, medical and support staff come into work each day at Alder Hey determined to do the best for our patients and those who care for them.

‘Justice Hayden has also commented upon the ‘diligent professionalism of some truly remarkable doctors and the warm and compassionate energy of the nurses whose concern and compassion is almost tangible’.

‘Unfortunately, these same remarkable staff have recently been the target of unprecedented personal abuse that has been hard to bear.’ 

Lord Justice McFarlane said there was evidence that Tom Evans and Kate James had made decisions based on incorrect advice.

The judge, who headed a panel of appeal judges considering Alfie’s case, said similar issues had arisen in other recent cases.

He said there was a ‘darker side’ to some offers of support and suggested that some form of investigation should be staged.  

Christian Legal Centre, the pro-life organisation behind Alfie’s legal team, said an air ambulance was ‘on hand’ if needed.

The Italian government has also offered him a private jet while the Pope, who met Mr Evans last week, said he hoped that the parents’ ‘desire to seek new forms of treatment may be granted’.  

A Polish flag flies outside Liverpool's Alder Hey Children's Hospital, in support of Alfie Evans. The Polish President weighed in today in support of Alfie's parents

A Polish flag flies outside Liverpool’s Alder Hey Children’s Hospital, in support of Alfie Evans. The Polish President weighed in today in support of Alfie’s parents

Tom Evans, Alfie's father, pictured speaking to supporters outside the Liverpool hospital last night, but the family will return to court again later

Tom Evans, Alfie’s father, pictured speaking to supporters outside the Liverpool hospital last night, but the family will return to court again later

Tom said his child will need further medical assistance within the hour if he is to survive the day

Doctors ended up giving Alfie oxygen and water

Medics have given the boy some oxygen and water but Mr Evans said his son (pictured today) will need further urgent medical assistance if he is to survive the day

 

Mr Evans pleaded in a Facebook post today: 'Please save our son, your Lordships'

Mr Evans pleaded in a Facebook post today: ‘Please save our son, your Lordships’

The removal of life support comes after the family lost a 'last-ditch' appeal to delay the withdrawal of treatment and mount a further legal challenge

The removal of life support comes after the family lost a ‘last-ditch’ appeal to delay the withdrawal of treatment and mount a further legal challenge

Alfie Evans is in a 'semi-vegetative state' and has a degenerative neurological condition

Alfie Evans is in a ‘semi-vegetative state’ and has a degenerative neurological condition

Tom Evans pictured with the Pope, who has thrown renewed support behind the family

Tom Evans pictured with the Pope, who has thrown renewed support behind the family

Parents of Alfie Evans took different lawyers to their latest appeal 

The parents of Alfie Evans were represented by different barristers for the first time during yesterday’s Court of Appeal hearing, it has emerged.

Paul Diamond, who had been representing both Tom Evans and Kate James in the ongoing battle over Alfie’s treatment, spoke only on his father’s behalf. 

Judges heard that Jason Koppel QC was now representing Ms James, having spoken to her on the phone and reportedly not had time to read yesterday’s High Court ruling. 

Mr Diamond, who works for the Christian Legal Centre, had been rebuked by Mr Justice Hayden at yesterday’s hearing for attempting to take the ‘moral high ground’ in the case. 

A  Sky News reporter at today’s hearing said judges had ‘expressed concerns’ after it emerged the two parents had different counsel. 

Mr Coppel previously represented the Government in its legal battle over Parliament’s role in triggering Article 50 to leave the EU.

He had only come to the case at the last moment and had not had time to read Mr Justice Hayden’s judgment at the High Court, the Mirror reports.  

At the start of yesterday’s hearing, Mr Diamond said: ‘It’s really an application for common humanity and common sense.’

But the judge interjected and told the lawyer to ‘confine himself to the law’ and avoid ’emotive nonsense’, later adding: ‘I don’t need to be reminded we have a human being. You do not have the moral high ground in this court. It is treacherous terrain.’

Mr Diamond is Standing Counsel for the Christian Legal Centre, and is described on their website as a ‘Defender of the Faith. ‘      

Doctors in Liverpool, who believe it is in Alfie’s best interests to have life support switched off, say he cannot survive and that a trip to Rome would be wrong and pointless.

At a special High Court hearing in Manchester on Tuesday, Mr Justice Hayden refused to let him fly to Rome, saying the long-running case had reached its ‘final chapter’.

One of the hospital doctors said the soonest they could move him home would be three to five days, but that ‘hostility’ to doctors would make that impossible and that there was ‘genuine fear’ among medics. 

Mr Evans claimed that he and Alfie’s mother ‘had to give him mouth to mouth resuscitation to keep him alive because his lips turned blue’.

A doctor giving evidence, who cannot be identified for legal reasons, said: ‘If I was being honest I think in Alfie’s situation [a return home] would have to be staged. I do not feel confident that we can say right now we can just send him home.

‘We have to be sure we can work with the family and we are not going job obstructed by the supporters who are threatening us and posting things on Facebook.’ 

At the start of the hearing, Mr Diamond said:  ‘It’s really an application for common humanity and common sense.’

But the judge interjected and told the lawyer to ‘confine himself to the law’ and avoid ’emotive nonsense’, later adding: ‘I don’t need to be reminded we have a human being. You do not have the moral high ground in this court. It is treacherous terrain.’

Discussing Alfie’s care, the judge said: ‘The options of palliative care are to be discussed with Alfie Evans’ parents with the objective of promoting a removal from hospital if possible.

‘All this is to be predicated on the premise that the plan is to promote the best options for end of life care.  

‘There is no change in the degenerative state of his brain. There is capacity for something of his brain stem to generate breathing.’ 

How do medics reach decisions in cases such as Alfie Evans? 

Why would the decision to withdraw treatment from a child be made?

Professor Russell Viner, of the Royal College of Paediatrics and Child Health, said: ‘Every action and decision is taken in the best interests of the child, and decisions on care, including the withdrawal of treatment, are always made with the involvement of parents.

‘We can’t comment on the specifics of the case, only the medical team treating Alfie, and the legal team, will know the exact details and they are bound by patient confidentiality.

‘However, we feel it is important for the public to know that decisions to withhold or withdraw treatment from a child are not made lightly.’

In what circumstances does it happen?

According to the UK’s framework, treatment is withdrawn if it is unable or unlikely to result in the child living much longer, where it may prolong life but will cause the child unacceptable pain and suffering, or if an older child with a life-limiting illness repeatedly makes it clear they do not want treatment and this decision is supported by parents and doctors.

How often are decisions like this made?

Prof Viner said decisions on withdrawing treatment from children are made ‘frequently’.

He said: ‘In the vast majority of cases an equal decision is made to withdraw treatment and it is rare that there is disagreement.

‘The cases where this is a significant difference in view are the ones that grab the media headlines.’

Why is Alfie continuing to breathe after life support treatment has been removed?

Professor Dominic Wilkinson, consulant neonatologist at the John Radcliffe Hospital and director of medical ethics at the Oxford Uehiro Centre for Practical Ethics at the University of Oxford, said: ‘In the last few hours, news reports have indicated that life support has been withdrawn from Alfie, and that he is breathing by himself.

‘That does not mean that doctors were wrong, and it does not mean that breathing support should be restarted.

‘The reason for stopping the breathing machines is simply that his serious condition is not treatable, and will not improve.’

He added: ‘Given the nature of Alfie’s condition, the doctors have wanted to provide him with palliative care, focused on his comfort, and focused on making his remaining time as good as possible.’

Is it euthanasia?

Prof Wilkinson said: ‘Providing palliative care is not euthanasia.

‘It is about providing ‘intensive caring’ rather than intensive medical care.

‘It does not end the child’s life.

‘Rather, it supports the child, and the child’s family, for as long or as short as they remain with us.’ 



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