Judgment was handed down yesterday in the case of Indi Gregory, an 8 month old baby. In October, Mr Justice Peel approved the Hospital Trust’s care plan and authorised the withdrawal of life sustaining invasive treatment to Indi, who was on full life support, critically ill and extremely unstable. Her conditions were irreversible and untreatable with no prospect of improvement.
Mr Justice Peel was satisfied that Indi showed little awareness of the world around her, had extremely limited quality of life and experienced frequent pain, multiple times a day, as a result of the various medical interventions required to sustain life. This pain was demonstrated through Indi crying, her heart rate increasing and her wincing and gasping.
After that judgment had been handed down, the Trust intended to withdraw treatment on Friday 27 October but agreed to extend this to Monday 30 October to meet the parents’ wishes.
Surprisingly, on the morning of Monday 30 October, the father’s newly instructed solicitor emailed the parties providing documents and asking the Trust to agree to Indi being transferred to Rome. Later that day, a formal application was made to the Court for Indi’s care to be transferred to other medical professionals. This application was opposed by the Trust and also the Children’s Guardian, who was particularly concerned about the pain and suffering that Indi was experiencing.
Mr Justice Peel heard the case on Tuesday 31 October and was clear that nothing he had seen or heard had led him to question the conclusions he had previously reached about what was in Indi’s best interests, and there was no compelling new medical evidence to justify him revisiting that decision. He was satisfied that a transfer to Rome would not be in Indi’s best interests.
Mr Justice Peel stated: “I reached a clear conclusion that invasive life sustaining treatment is no longer appropriate for IG. The substantial burdens of such treatment significantly outweigh any perceived (but in my judgment negligible) benefit, in a context where her life expectancy is very short, and her conditions irreversible. Put another way, there is nothing to suggest that IG’s prognosis would be beneficially altered by the Italian hospital’s treatment. On the contrary, it may well prolong pain and suffering if and to the extent that it incorporates invasive procedures which in my judgment are not in IG’s best interests, and should not be sanctioned.”
These cases are always tragic and I cannot even begin to imagine how difficult this must be for Indi’s parents. I know from other cases the toll they take on the treating team and nursing staff, and how important it is to ensure those involved are well supported, which is echoed in Recommendation 12 from the Nuffield Council on Bioethics Review of disagreements in the care of critically ill children.
For further information, please contact:
Emma Pollard, Hill Dickinson
emma.pollard@hilldickinson.com
