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Dublin: 15 °C Saturday 25 May, 2013

High Court rules boy, 6, with brain injury should not be resuscitated

Resuscitating the boy, who sustained a serious brain injury after nearly drowning four years ago, is ‘not in his best interests’.

THE HIGH COURT has ruled that a six-year-old boy with serious brain injuries should not be resuscitated if his condition deteriorates further.

The court granted an order sought by an unnamed hospital which had asked that the child not be resuscitated if doing so required invasive treatment, which is medically advised not to be in his best interests.

Justice Nicholas Kearns, delivering the ruling this morning, said the boy – known only as SR – was “an energetic and bright child” until his accident, which left him with no prospect of recovery.

“The medical evidence is both unanimous and contradicted that re-ventilation would not be in his best interests,” Justice Kearns found.

While he accepted that there was “a strong presumption” that any ill person should be given the appropriate medical attention needed to save their lives, this could be “deviated from in exceptional circumstances”

In this case, it was found that re-ventilating the boy - who was 22 months old at the time of his accident, and who has since been taken into the court’s care – would caused unnecessary pain and discomfort, and would be futile in terms of a long-term recovery.

The child’s parents had opposed the hospital’s application, with his father saying he had discovered stem cell treatment which could be administered in North America, and which he felt could improve his child’s chances of recovery.

Justice Kearns disagreed with this, saying he did not believe that the treatment offered “any real prospect of changing or ameliorating SR’s condition”.

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Comments (29 Comments)

  • that is so sad!! imagine those parents have watched their boy grow from 22months to 6years old all the while he is in a coma…so sad i pray for them…

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  • Maybe its the best for the child but the family can’t see it

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    • Possibly,but I can’t imagine letting my son die like that either,I think you would cling on to any hope no matter how impossible it would seem to someone else. So sad and so hard for the parents

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  • All concerned are in my thoughts and prayers . I hope this family and their son will not suffer any more . Whatever the future will bring .

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  • Puts the state of the country into perspective… Hope his parents find peace.

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  • Such a sad story.. poor kid.
    :’(

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  • kyp154 11/01/12 #

    Awful position for the parents to be in, realistically if they managed to raise the tens or hundreds of thousands, maybe more, to go to the US for stem cell research, they would be looking at ridiculous odds of it working, but as a parent they couldn’t NOT try, even if the child remains in a coma permanently, or comes about with ‘only’ major brain damage, he is still their son,even as a vegetable, they couldn’t consider giving the decision that would ultimately end his life. Heartbreaking for their parents and your heart has to go out to them

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  • I’ve deleted a few comments on the request of their author, and a few others which were posted in response to the original.

    It should be noted that the site doesn’t offer the ability (yet) for users to delete any comments they have already posted on the site; I’m not sure what some users are referring to when they say ‘I deleted my comment’ because there is no such function. Ergo, it’s not correct to say that I (or any other Journal staff) am personally intervening to make sure that a comment remains visible even when its author has ‘deleted’ it – there is no way for them to delete it in the first place.

    Any user who wants one of their own comments to be deleted can ask for it to be removed by hitting the ‘Report this comment’ link beside each appropriate comment.

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    • Wrong place to post it, as I’m sure you’re not a dev for the site but here goes ) Just to bring to someones attention.
      There does seem to be something wrong with the comment thread on this page as I just created a comment and it was put above comments made ’7 hours ago’ (At time of writing)

      It might not be the case in 5 mins time as this sometimes rectifies itself, just thought I’d let you know!

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  • I understand your angle Dee, I really do. But the world we live in is not an ideal one. We do not have unlimited resources that we can waste without thinking of the consequence. For example, even in this case… Is it ethically right to spend so much on a child that we can say with 99.9% accuracy will never recover any meaningful quality of life, when spending that money will also mean NOT having the money to treat 2-3 other children with newly diagnosed tumours that we know with over 90% accuracy will respond to therapy. These are the decisions faced by our hospital consultants on a daily basis. The answers are not easy. They are not always popular. And the most difficult of them end up in courtrooms because there is no other forum in which to decide upon them.

    I want the taxes I pay to make a difference to the people of ireland. And for that to happen they must be put to the best possible use. That demands difficult decisions, but impeccable ethics. Thankfully, that does seem to happen; at least most of the time.

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  • He isnt in a coma.

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  • Maybe he’s in the courts care because the family couldn’t afford the medical bills anymore? Is that a likely reason?

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    • No that is not it either . I think it is better not to speculate and I am sure that all concerned The family , the medical personel , the courts and any one else are all doing their very best for this child given the circumstances . The saying ”there are worse things than death” comes to mind . This is a very tragic situation .I have children and I am devestated to think of this little fellow and his family.

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  • Not to be insensitive… On the contrary, I am thinking of each and every taxpayer in this country that would otherwise be subsidising ridiculously expensive medical care for a very unfortunate soul who will never recover meaningful function. It’s a tragedy. But one that happened when the child was 22 months old. The tragedy now is that it has continued so long.

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    • cautiously, i have to say that i am inclined to agree with this position, especially if you combine it with considering what quality of existence the poor child will ever have. sometimes we need to quietly let go of our obsession with staying alive at all costs.

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    • Enda your comment is disturbing to even think of the cost to your pocket in circumstances like this its disgraceful. The suffering by both parents and child is unmeasurable. I’m sure if they thought there was any sort of hope they would cling to it. I know where I would want my tax money going instead of in our governments pockets.

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  • “not be resuscitated if doing so required invasive treatment, which is medically advised not to be in his best interests.”

    I dont understand how not being alive could medically be in someones best intrest!?

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    • Sorry for the insensitivity… Thoughts at this time with the family..
      Just wondering will this case be used as a precident in the future for Eutinasia etc.

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    • That boy was in a coma from which he realistically wasn’t going to wake up. Resuscitation is traumatic, good ethics requires us to consider the quality of life it would give to the boy, and whether allowing him to slip away would be better. An awful time and my thoughts are with the family

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    • What if that standard of life was one of pain and cruelty to the individual?

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    • Thanks, I wasnt trying to make an Ethical statement just wondering what was the logic of doctors who gave the medical advice. Im having trouble understanding the scentence – “which is medically advised not to be in his best interests.” Does that reffer to resusitation or the invasive treatment?

      Did the doctors give medical advice not to resusitate or not to give invasive treatment?
      The difference is I find it hard to believe doctors would not resusitate a patient on purely medical grounds..

      Isnt it Hypicritical for a doctor to say death is what’s best for the patient? (all moral implications aside)

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    • Ciaran, resuscitation is considered invasive treatment. It’s a common occurrence that doctors would consider withholding resuscitation in a patient. One of the four pillars of medical ethics is non-maleficience, or “do no harm”. This is separate to beneficence, or “do good”. The doctors would be harming the child with very little gain. Unfortunately in this case resuscitating the child would not have improved matters. The parents plight is heartbreaking but sometimes an objective viewpoint is needed to do the right thing here. Ar dheis Dé go raibh a anam

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    • Also, there is a difference between Euthanasia (deliberate and active ending of life by medical means) and allowing someone to die to avoid causing further harm to them. Rescuscitation is an invasive process and can be extremely traumatic, and it is hard to justify it if the patient is likely to be worse off, or to continue suffering as a result. It must be terrible for the family to be faced with this.

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  • Constitutionally the State needs to step in and defend the right to life of this child. Article 40.3.1 “The State guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate the personal rights of the citizen”

    There may also be breach’s in International Civil Liberties.

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  • The fact the court award following the accident stated that the HSE had to pay for his medical care while he was alive, it’s cheaper on the state if he’s not alive. A sick sick state we live in!

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