Alfie Evans Case Renews Humane Healthcare Debate

Image: Katie James / Facebook
Image: Katie James / Facebook

by Adriana Watkins

 

Alfie Evans, a child removed from life support by a British hospital, died on April 28 after a lengthy legal debate surrounding his care. His case gained international attention in the week before his death, as his parents petitioned the court to overturn the decision that would remove him from his ventilator. Evans’ situation has been compared to that of Charlie Gard, who died in 2017 after a similar court-ordered removal from life support. 

Evans was born in May 2016, and was hospitalized several months later with a degenerative neurological disease. His condition could not be diagnosed by doctors at Alder Hey Children’s Hospital, where he remained a patient for 18 months. He was classified as being in a “semi-vegetative” state, and his physicians could not treat him. Because of this, a court ruled in favor of withdrawing his life support. The decision was made in March, with a date set for April.

            

Though Evans’ parents challenged the ruling, it was upheld, and the boy was removed from support on Monday, April 23. Contrary to doctors’predictions, he continued to breathe on his own for several hours. As he continued to survive, the court again upheld its decision to discontinue life-giving care. Furthermore, Evans was denied nutrition, fluids, and oxygen until the next day, prompting outrage from the public and from his parents, who posted on Facebook, “How is this HUMANE[;] where does his DIGNITY LIE”[sic]. 

            

The situation bears similarities to the 2017 case of Charlie Gard, a British infant who was denied experimental treatment for his genetic disorder. The British courts ruled to remove life support in Gard’s case as well, against the wishes of his parents. Pope Francis denounced this decision, joining a number of international leaders who expressed concern. Gard died on July 28, 2017, shortly before his first birthday. 

            

Alfie Evans’case gained similar attention as it became apparent that the court would not waver in its decision. Poland and Italy denounced the ruling, and Vatican City extended its prayers to the Evans family. On the day the boy was removed from life support, Italy granted him citizenship so that he could be taken there for care and treatment. Pope Francis ordered an air ambulance to remain on standby; however, doctors at Alder Hey determined that the transport would not be in Evans’best interest, and they did not allow him to leave the hospital. 

            

The pope maintained public support for Evans and his parents throughout the ordeal, meeting with the child’s father, Thomas Evans, on April 18. Later in the week, he said via Twitter, “I renew my appeal that the suffering of his parents may be heard and that their desire to seek new forms of treatment may be granted.”

            

Despite the international support and public outcry, Evans was not transferred to Bambino Gesu Pediatric Hospitalin Rome. He died at 2:30AM on Saturday, April 28. His parents posted about his death on social media, saying, “Our baby boy grew his wings tonight…We are heart broken.” The pope extended his consolations.

            

Evans’case joins a heated discussion in the international medical community about the limits and responsibilities of end-of-life care. Because Evans was granted Italian citizenship, legal discussion commenced about a possible murder prosecution in the event of Evans’death. Going forward, the conversation around Evans includes both concerns about state authority and, more broadly, questions of medical ethics.

            

In court on Wednesday, after Evans had breathed on his own for many hours, Justice Anthony Hayden of Great Britain and lawyer Paul Diamond discussed the boy’s care. Diamond, who represented the Evans family, said of Evans, “We do have a human being.” Justice Hayden responded, “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.”

 


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