An NHS Trust v Child B and Mr and Mrs B  EWHC 3486 (Fam) – read judgment
I posted earlier this year a discussion of Ian McEwan’s pellucid and moving account of the difficulties encountered by judges when steering between the rock of parental faith and the hard place of children’s best interests (The Children Act, 2014).
This judgment, although handed down four months ago, has just been published, and confirms that judges may be resolute, however politely, in the face of parents’ insistence that they know what is best for their children.
The application concerned a very young child (B) who sustained burn injuries in an accident. The clinical team responsible for his care advised that the best practice treatment for his injuries was skin grafting and that there was a significant risk that he would require a blood transfusion . To avoid infection and for the best possible result, skin grafts should be carried out no later than 7 to 10 days from the initial burn. The Court was also told that in the event of a skin graft taking place without the ability to give a blood transfusion, there would be a risk of death as a result of sepsis developing.
B’s parents are both devout Jehovah’s Witnesses and as a result of their faith they did not agree to and object to B being given blood transfusions. They could not accept blood being provided to B during the course of any operation or indeed under any circumstances because blood, in their faith, is sacred.
As B is a child, no one else could give consent for this treatment other than this court.
The Court’s decision
It was clear to Moylan J that it could not be in B’s best interests for him to be exposed to a risk of death – however small – if that can be avoided. As Ward LJ said in In re A (Children)(Conjoined Twins: Surgical Separation)  Fam 147,
although I must give “very great respect” to the parents’ wishes, they are “subordinate to welfare”
The risks consequent on a blood transfusion are nothing like the nature of the risk to which B would be exposed if he were not to receive a blood transfusion.
The judge therefore made the order in the terms sought by the NHS trust.
The American biologist Jerry Coyne comments in his blog that he was struck by Mr Justice Moylan’s courtesy when dealing with such “religious inspired” obduracy:
although … parents [in these kinds of cases] insist that they are good parents, they show a striking lack of affect concerning the death of their child. Time after time I’ve read about parents martyring their child for their faith, and then showing no remorse at all about it—often ascribing the child’s death to “God’s will”.
A little harsh perhaps, but Coyne has a point which he discusses at greater length in his book Face versus Fact. Two points strike him about these kinds of cases, which obtain in this country as well as the States:
The first is that the parents usually either get off scot-free or are given a legal slap on the wrist, although if they withheld medical care on other than religious grounds they’d be punished severely for child abuse, mistreatment, or neglect.
The picture on the left incidentally contains images of children who have died in the United States as a result of refusing transfusions.
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