Tuesday, 24 April 2018

ALFIE EVANS

 ALFIE EVANS - PLEASE JUST STOP!

British Medical Journal April 24, 2018, by Iain Brassington




Last summer, as the Charlie Gard saga was unfolding, was a slightly strange time to be a bioethicist.  Perhaps fortuitously, I was out of the country as matters began to gather pace; I was able to post a couple of blog posts (like this and this), but could generally keep my head down until I’d had time to work out clearly what was what.  Eventually, I felt that the time was right to respond to requests from the media for comment.  Dominic Wilkinson did sterling work on that front, too.  I’d like to think that, between us, we did a pretty good job (he better than I, for sure) of explaining what the moral and legal arguments were, and which were the stronger ones.

Alfie Evans is a child whose position is, on the face of it, very similar to Charlie’s.  I’m not going to rehearse the details of his case here.  Suffice it to say that he is terribly unwell, and supported by a ventilator.  The medical team treating him at Alder Hey hospital in Liverpool has decided the further treatment would not be in his best interests.  This is disputed by his parents.  As a result, his case has been heard on multiple occasions at all levels of the legal system: it’s been to the Supreme Court twice.  Today (as I write this on the evening of the 23rd), the European Court of Human Rights rejected Alfie’s parents’ latest petition.


ALFIE'S PARENTS


From what I can tell from the media coverage and the court reports, the decision to withdraw treatment from Alfie is wholly defensible.  I would not support his parents’ ongoing legal battle; I think that they should drop it and that by not doing so, they risk prolonging their son’s suffering.  I take it as a given that this is not their intention.
On that front, then, there’s not a great deal to say.  But.

There have been reports of supporters of Alfie protesting outside the hospital, which has made things intimidating to other patients and medical staff.  There’s a Facebook status update doing the rounds from a woman who claims to have a child in Alder Hey – and why would anyone doubt her? – who reports that there’re people suggesting that Alfie’s supporters should set off fire alarms in the hospital.  The BBC has reported that people have tried to storm the hospital.  (As several people have asked: What would they do then?)

And, ramping up the weirdness, as I write this – it’s a touch before 9pm now – I learn that the Italian government has granted citizenship to Alfie… for some reason.  There have been offers from Italian doctors to keep Alfie on a ventilator, so presumably, the idea would be that, as an Italian citizen, he’d be protected by Italian law.  But I’m struggling to make sense of this, what with him being in Liverpool.  Whatever Italian law has to say on the matter of withdrawing treatment is moot; and – as reiterated in the Court of Appeal last Monday – the Courts are satisfied that the withdrawal of treatment and provision of palliative care should take place at Alder Hey (see paras 21 and 25, and passim).

I’m also a touch curious about how Italian citizenship law would work here anyway.  The law itself is visible here.  Most of the criteria have to do with descent, marriage, or residence.  However, Article 9.2* says this:

By decree of the President of the Republic, having heard the Council of State and following a decision by the Council of Ministers, upon a proposal of the Minister for the Interior, in consultation with the Ministry for Foreign Affairs, citizenship may be granted to aliens where they have rendered an outstanding service to Italy, or where an exceptional interest of the State exists.


ALFIE'S DAD WITH POPE FRANCIS


I take it as read that Alfie has not rendered an outstanding service to Italy.  It must be, then, that it is in the exceptional interest of the Republic that he be a citizen.  But what interest could that possibly be?  A state might have an interest in protecting its citizens abroad, but it’s hard to see how it might have an interest in making them citizens in the first place.  And would the same interest be found in any and every seriously ill or imperiled child?  This would be important to know for the refugees who’re still being picked up from the Mediterranean and some of whom at least wind up on Italian soil.

Or… and stick with me on this… it might be that the relevant ministers have seen an opportunity here.  They know that offering Alfie citizenship won’t make any difference; it's therefore an easy win for them politically.  They look magnanimous, leaping to the aid of a dying youngster.  Nothing at all will happen to the dying youngster in question, of course, but the gesture has still been made.  The Italian elections having been held three weeks ago is a slight wrinkle in the theory – it’s not like there’s electoral capital to be gained – but I don’t have the imagination right now to come up with another explanation.
If there’s anyone out there with expertise on Italian politics and immigration law, please do drop me a line; I’m baffled.

Where’m I going with this?

OK: look.  The legal question is straightforward, as is demonstrated by the lack of difficulty the courts at all levels have had in ruling that treatment may and should be withdrawn.  The moral question is also straightforward, I would contend.  If there is a risk that Alfie is suffering, treatment should be withdrawn; if it is doing him no particular good, there’s no reason to keep it, and so it should be withdrawn on pain of being arbitrary (and, to be blunt, to release resources).

Medical ethics is primarily about the moral standards incumbent upon medical professionals.  But I don’t see why it should be about that entirely.  It’s also about more general moral reactions to medical possibilities and procedures, and about the moral evaluation of the context in which medicine happens.  So I don’t think that I’m stepping out of line from the aims of this blog (whatever they are – I think we’re still making them up as we go) by expressing this stuff.

My worry here is that even more than in the Gard case, what we see here is a child being bounced around to satisfy the desires of a number of adults, most of whom have nothing at all to do with him beyond membership of a couple of Facebook groups.  I’m reluctant to criticise Alfie’s parents, because – though I think they’re terribly mistaken – they’re clearly committed to their son.  Those outside the hospital, on the other hand, are much more open to criticism.  I’ll go further.  There is something grotesque about the protests, and about the Italian move.  Mawkish.  Saccharine, but with a threatening undertone.  It’s horrible, irrational, indefensible, and – for want of a better word – nuts.  It would be a morally better world without these responses.  But, I suppose, even their protests have something at their core that is not wholly without merit.  These are people who do care, notwithstanding that they’re showing it in a deeply counterproductive way.
Lowest of the low, though, are politicians who’re weaponizing the case, whether they be in Italy, or here.  Tory MP Edward Leigh has just tweeted this:

A UK hospital is holding an Italian citizen hostage and intends to deprive him of life-giving treatment against the wishes of his parents. @BorisJohnson & @foreignoffice must act quickly to let Alfie live. https://t.co/rJtMBGXhzs @ItalyinUK #AlfieEvans #AlfiesArmy
— Sir Edward Leigh MP (@EdwardLeighMP) April 23, 2018


I’ve taken a screenshot, for when – almost inevitably – the tweet is deleted.  In the meantime, let’s just satisfy ourselves by pointing out that his intervention is either culpably misinformed (on the basis that MPs have a duty to think before they tweet) or culpably duplicitous; and either way, it’s utterly contemptible.  And when there are stories of staff and patients at a hospital facing physical intimidation, it’s dangerous, too.

PAT SAYS:

This is a very tragic and sad case - especially for Alfie's mother and father, Tom and Kate.

Of course, they want to do everything they can to preserve the life of the little baby boy they brought into the world.

Many of have had to face the eventual death of a loved one after we had exhausted all the roads - medical and otherwise - to saving their lives.

When we lose that person not only is there great sadness and grief but there is the overwhelming sense of having failed to save them.

Losing a child must be one of the greatest losses of all.


But on this occasion, I must agree that the doctors and the courts have made the right decision.

People like the pope, the Italian government, and the protestors have not helped.

They all have their own agendas.

The doctors and the courts only have one agenda - that which is in the best interests of Alfie himself.

In cases like this, we need the courts to step in and make the right decision on behalf of the suffering person.

Of course, I fully believe that Tom and Kate's agenda is love.




48 comments:

  1. I agree totally. This is a wise and rational article, but wisdom and rationality are not in vogue is our world.

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    1. Try being Alfie's parents for a moment or two.

      We humans don't live on planet Vulcan, where logic is the guiding principle of social interaction.

      And not all wisdom and rationality come from the head: they can come also from the heart.

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  2. These cases are always dreadfully sad when the desolate parents cannot bear to give up hope and just cannot reconcile themselves to accept the inevitable.

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  3. It is very important to realise that agreeing to accept the advice of the senior medical Staff to have the life support machine turned off when everything possible under the sun has been tried in the way of treatment is NOT euthanasia .. Far from it. The two should not be confused.

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  4. Interesting topic. But, its not your child.

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  5. The medical people have debated. It would appear Alfie sadly will not get better. He would appear not to have any quality of life at present. We can always pray for a miracle but what would God want at this moment in time. I also imagine £ signs are flashing somewhere. Who is paying for the treatment and is the treatment a waste at this point in time. Whatever happens I entreat everyone involved to God's love and care

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    1. Sometimes the miracle is that God is willing to bring any of us home into his loving embrace. It is sad but we do pray daily "Thy will be done" and that is a far cry from praying "My will be done". May God comfort these parents with whom he has entrusted the short life of this child.

      I agree with you Sean, we need to entreat all to God's love and care.

      Peace to you Sean my fellow poster. CR

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  6. MourneManMichael25 April 2018 at 08:29

    And many people continue to believe that there is an almighty loving God watching over and interested/involved in every aspect of humankind's daily lives?
    Without reference to that much contested set of manuscripts, the Bible, please explain.
    Thank you.
    MMM

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    1. I am fortunate to have a very deep prayer life. I can usually find within myself the strength to cope with any thing that comes my way. It is the treasure in the field. You have to put in the time round out that the kingdom of heaven is within you.
      Bad things happen but God and I are in it together.

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    2. 11:28, 'God and I are in it together'? Fine, in so far as it goes, but it doesn't go far enough for me, I'm afraid: I don't want company in suffering; I want help. And if God cannot, or will not, help, then he can 'do one'.

      Paul Claudel expressed his tuppence worth on this subject pithily (but this is about all it has going for it): 'Jesus came not to explain suffering, or to remove it. He came to fill it with his presence.' (Whatever the hell that means)

      Jesus offers more than mere presence: he offers help; he offers to alleviate human suffering, and to guide one in it. But it is conditional: on someone's having faith not only in his ability to act, but also in his willingness to act.

      So Paul Claudel, keep your Jesus, who merely watches while one suffers, but who callously withholds his supreme power over pain and evil. Why would I (why would any reasonable person) have faith in that kind of God?

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    3. We can be absolutely certain that the 20th century philosopher and thinker had a much more profound and nuanced concept of God and his faith/relationship with God, than the little mind of the internet troll at 16:59 is capable of dealing with.

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    4. 21:13, the only thing of which YOU (and we) can be certain is your transparent stupidity (and, therefore, your existence).

      As Descartes might say of you in existential proof: Non cogito ergo sum!😆

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    5. Internet troll at 23:50, what a scintillating display of your superior intelligence. Bravo!

      And you know a little bit of Latin too, as well as a little bit of everything else! A veritable polymath or should one say HOMO universalis?

      A “jack of all trades” and that other bit about being a Master .....

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  7. The Pope is stepping outside his speciality field. He cannot know.

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    1. The pope has prayed for a miracle for Alfie and God has ignored him. Shows how little influence the pope has with God!

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    2. MournemanMichael25 April 2018 at 10:42

      Might one also reasonably argue that there is no God?
      MMM

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    3. @10.10
      I am shocked at how off - course you are!
      Is that how you see prayer and the nature of prayer!
      Do you think that prayer is about us demanding that God does our will and that only OUR answer to the prayer is acceptable!?!!
      If the Pope has prayed you can absolutely be assured that those prayers have been heard. Don't ever think or say that God doesn't hear all our prayers, including yours and mine.
      The prayers of the Pope will be answered in ways that may be far outside our understanding this side of eternity . He may have prayed for calmness, peace of mind and acceptance on the part of the grief-stricken parents.
      Please do think about the nature of prayer and how very powerful it is and above all, about the nature of God's response when He sees what is best in a way far beyond what our limited vision of a situation permits.
      Your comment shocked me with its vindictive edge which was so far from how God responds when His people appeal to Him ..Prayer is not about demanding that God bends to our will and no-one knows that better than Pope Francis. His prayers were answered, rest assured of that.

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    4. 08 59: The Pope did not step outside his speciality. He offered hope, prayer and comfort to a grieving family. His fervent prayer was simply one that "hoped" all would and could be done for Alfie and his parents. Nothing wrong with being kind, compassionate and hope-filled. God bless Alfie and his parents. Life is sacred at every moment.

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    5. MMM 10.42: In the face of suffering we may well argue and ask - where is God? Does he exist? We could also argue that God is very much present/existing through the immense care, love and assistance given to Alfie through the many professional people around him and especially through the deep, unconditional love of his parents. Jesus made God tangible, present, real for us. We make this Christ present through our love, kindness and compassion in all ways possible. I know I have experienced the closeness of God to me in struggles, darkness and illness through the prayers, kindness and support of others.

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    6. 16:09, MMM was, I think, asking something like this: if God exists, then why the heck won't he heal little Alfie and make everyone happy? Is it really such a big 'ask' for a god who claims to love humanity.?

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    7. MourneManMichael25 April 2018 at 18:59

      Spot on Magna.
      No sensible answers or responses so far.
      I've asked similar questions in the past. There's usually a deafening silence in response, or alternatively 'answers' heavily reliant on individual's personal faith beliefs with absolutely no convincing evidence of any sort put forward.
      Each to their own belief for sure, but I remain completely unconvinced of the existence of any deity by anything I've seen, read, or heard. So I think it only reasonable for me to believe that it's not for me to "disprove" the existence of God: it's for those who believe, if indeed they so choose, to provide even a shred of evidence.
      MMM

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    8. I think faith is a grace. Not everyone has it. I didn't, until in a crisis, I absolutely and totally surrendered to God and became aware of a presence. I think you have to make the jump.

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    9. 18.59: MMM, your comment, while expressed carefully, is still an attempt to demolish a faith perspective. You are entitled to your world view and I respect that but for me, almost 60, with much philosophical and contemporary psychological studies I am not convinced of the "non existence" of God. In fact my learning through the years has enriched my faith perspective of life. Suffering is an inexplicable reality but my faith inspires me, insofar as possible, to alleviate it when possible. Suffering and pain are an intrinsic part of being human and when we are indifferent or selfish, that suffering can be deepened. I believe God works through each of us in different ways.

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    10. Pope praying for a miracle. Why not. It would be foolish to think the Pope or anybody else controls God. I know God does work and answer prayers. I have seen it this week in relation to my new job. Pray for Alfie and family. Dare to ask the question and share the journey in prayer and fellowship. Jesus said ask and you will receive. In faith and openness let's see what God sends.

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    11. Suffering is a perfectly explicable reality, 20:32: it occurs because humanity is finite and so must physically die.

      Death is an experience for which humans were not created and so is contrary (painful) to our nature.

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  8. I know it is a bit off topic, any update on the Little Brothers? We haven't heard about them for a while and I was wondering if they are still functioning? Was there a web-site due to go up about them and their work?

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    1. Good question.
      I enjoyed reading Maureen's sermon from Sunday. Hopefully one of the brothers might share his thoughts with us in this Easter season.

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    2. The Brothers are still there but evolving into something unplanned. Will update when we can.

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    3. evolving into something unplanned? Could you say a bit more about what you mean, +Pat?

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    4. Evolving from a community all living together to a community where people do not live together but come together for Eucharist, prayer and pastoral work.

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  9. 11.14: The mysterious evolving nature of the Little Brothers was expected as there has been too much secrecy around their raisin d'etre; their real identity; their teaining; their core values; their mission; their status as a living, vibrant community, in community with one another - not isolationists. May as well be hermits. Also, Pat, the financial costs of this venture must be worrying for you. I don't agree with most of your perspectives or vision, but I was interested as to the on-going development of your community. I follow the story of Silverstream Community in Stamullen and their evolution is fascinating. Keep us updated.

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    1. A very different ecclesiology. That's why they are growing.

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  10. The story of baby Alfie and his parents touches all our hearts. The decision to be made is very challenging for all concerned. Alfie's parents love him so much, value his beautiful, precious, significant life and want him to live. What inspiring love, full of hope, compassion and expectation. Real true love. Prayer for Alfie and his parents is important. His parents obviously believe so and we must never take that hope away from them. Pope Francis offered prayer as he would with and for anyone whom he embraces. His fervent prayer is not interference. For those who are atheist or non believing, the concept of prayer is often unfathomable. But strangely, many a non believer is frequently heard saying..."oh my God"! in face of challenge, beauty and mystery!! God loves unconditionally and hears our prayer, not as we may wish but often the response is strength, comfort and inner peace to face our sufferings. St. Padre Pio said : "Prayer is the key that opens the door to God's heart." I find this inspiring, so let's continue our prayers for Alfie and his parents.

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  11. Absolutely understand what the doctors are saying. At the moment there are large numbers of people in prayer asking for the intervention of the Holy Spirit in the case of Alfie Evans. As followers of Christ we have faith that the trinity does have the power to control this situation for His will and His Glory. That's what we pray for. But remember if you do believe that His people were led out of Eygpt with columns of fire . The sea covered riders and horses. The walls of Jericho did fall down. Jesus said that the daughter of Jarius was only sleeping and Lazarus was in the tomb for four days and he was starting to decompose. So we pray for His Mercy and that He takes full control over this situation .

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    1. Bamboo Gesu is probably very short of money since it's funds of 422000 Euro were used to decorate Cardinal Bertones appartment. You really couldn't make this stuff up!

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    2. 15:19, 'His people were led out of Egypt with columns of fire'? 'The sea covered riders and horses'?

      Are you a fifth grader? Because your literal and unqualified belief in the Exodus places you around that age.

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    3. Does Magna genuinely think that that 15.19 is a "fifth grader" If so, then something is very worrying...

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    4. Why is it read at the Easter Vigil? Should the reader do it it in an ironic style or with fingers crossed behind their back?

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    5. 19:56, so, too, is read the first creation account in Geneis, but we don't take that as historical truth, do we? (You don't, do you?😲)

      Try to remember that some authors of Scripture (especially of the Old Testament) were more storytellers than chroniclers. (Which is a polite way of saying 'they made "stuff" up, including "stuff" about the Exodus'.)

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    6. I personally have always believed the parting of the Red Sea. C.S. Lewis wrote about the gnats and the camels. Once you start deconstructing and rationalising every part of the Bible what of it remains believable.

      We had a curate in Enniskillen, Fr Michael Hand (he ran off in his 2CV with a German woman, resurfaced in Omagh, now on his second wife, who is his third vocation).

      Anyway, Michael Hand liked to provoke his congregation by saying that the Gospel was mostly lies.

      One day a parishioner came into the sacristy and asked why the loaves and the fishes was more or less credible than the Virgin Birth, Immaculate Conception or the Resurrection. Michael Hand had dismissed the loaves and the fishes as a story of people sharing what they had.

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    7. 20:23, to understand Scripture too literally in places is to misunderstand its literary type. It's like the parables: made up tales to make important spiritual points.

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  12. Unanswered prayer does not affect my faith.

    God is not a cow that we can milk.

    As Job said: "The Lord has given. The Lord has taken away. Blessed be the Name of The Lord".

    Of course there are very dark times on our journey.

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  13. 17:46 is the Bamboo Gusu for pandas? Francis managed to extort $25m from gullible US Catholics for a corrupt dermetoligical hospital in Rome, even though the money was supposed to go to the developing world. You really coudn't make this stuff up!

    http://www.catholicherald.co.uk/news/2018/02/21/popes-request-for-25-million-donation-to-scandal-hit-hospital-divides-charity/

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  14. Replies
    1. 19.46 It's the auto correct on my ipad. It has a mind of it's own

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  15. +Pat, you're a good person, but stop censoring comments about the little pooves.

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  16. +Pat, please do a blog on Cliff Richard. Try to explain this anomaly of manhood.

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