The recent case of Alfie Evans, a 23-month old who sadly passed away, has drawn huge attention in the media and has highlighted numerous ethical and legal issues at play within medical decisions.
Alife Evans was diagnosed with an unidentifiable degenerative neurological condition, and spent more than a year in a semi-vegetative state. His parents wanted Alfie to be flown to Italy to receive treatment in a hospital, however the hospital he was being treated at in the UK blocked this move, arguing it was not in his best interests. They argued due to the degradation of his brain tissue, further treatment would be “futile” and “unkind and inhumane”.
The key legal issue at play in the case was whether doctors have the ultimate right to decide whether withdrawing life-support treatment is in the best interests of a terminally ill child. However, the law in the UK does not offer a definitive answer to this question. The 1989 Children’s Act states that the state can intervene when a child is at risk of harm. This leads to a legal grey area, whereby the state can challenge the rights of the parents, where they believe they are not acting in the best interests of the child.
The case also highlights the complex interplay of the different medical ethical principles to be considered when deciding how best to treat a patient. The ethical principle of beneficence states that doctors should always act in the best interests of the patient and need to balance the benefits of treatment against the costs. However, patients also have autonomy and have the right to make decisions regarding their own treatment. In the case of a child, this decision falls to the parent, and this leads back to the crux of the case as to whether it is the doctors or parents who can decide this.
Law students could look at the complex legal issues involved in this case, and consider how these laws may differ between different countries. Both Philosophy and Medicine students should consider the ethical implications in the case and how these impact upon the decisions that were taken.
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