10.1.4 Disagreement between the family and the professional carers
Where there is serious disagreement about the best course of action, either the
family or the health care team 4backed by the relevant health authority) may ask
the High Court to intervene. Alternatively, social services may invoke the court's
jurisdiction. The court will take account of the views of all involved in caring for
the child and of the child's legal representatives, before reaching its own inde-
pendent assessment of the balance of advantages or disadvantages of the particular
medical step under consideration 4Re T a minor) wardship: medical treatment
41996)). The views of the nursing team can and should be very influential 4Re C a
minor) wardship: medical treatment41989)).
Although the courts' intrusion into family life could amount to unjustified state
interference under article 842) of the European Convention,it is usually deemed
necessary for the protection of health or morals, or for the protection of the rights and freedom of others'. The aim of safeguarding a child's physical, psychological or emotional welfare is thus considered to be a legitimate basis for court intervention. Understandably, treatment decisions concerning critically ill children have frequently reached the courts. InRe D wardship: medical treatment)42000) the applicant NHS Trust cared for a 19 month old boy suffering from severe, wor- sening, irreversible lung disease, coupled with heart failure, hepatic dysfunction, renal disjunction and learning difficulties. The Trust wished to spare him artificial ventilation in the event of respiratory or cardiac failure but his parents disagreed strongly with this approach. The High Court sided with the Trust in this case, finding that the benefits of a probably short extension to life-span were outweighed by the distress intensive mechanical treatment would inflict. Similarly, in the 1999 case of baby C, discussed in section 10.1.2 above, the High Court, despite the opposition of the parents, agreed with the health authority that ventilator support should be withdrawn from a terminally ill little girl. By contrast, inRe T a minor)wardship: medical treatment)41996), it was the parents who objected to medical intervention. T at the time of the hearing was 17 months old. He suffered from the life-threatening liver defect biliary atresia, and the medical recommendation was a liver transplant. He had had an operation already, and his pain and distress at that time had persuaded his parents that he should not undergo major surgery. Of the three transplant teams consulted, one was prepared to respect the views of the parents, but one was determined that a transplant should go ahead. The parents, who were themselves trained health professionals experienced in the care of young, sick children, found that their opposition to the transplant was referred to social services, and from there to the High Court. Although the High Court judge ruled that a transplant was in T's best interests, the Court of Appeal disagreed. The judges were not convinced that a short but happy life, ending in peaceful death, was a worse option thana lifetime of drugs
and the possibility of further invasive surgery'. Instead, they looked beyond T's
purely medical interests to the broader considerations' which applied and con- cluded that the views of the parents could be allowed to determine T's future treatment. Although inRe T,thebroader considerations' were put forward by the
198 Nursing Law and Ethics