My research explores the suitability of using objective legal principles to resolve medical disputes regarding the continuation of life-sustaining medical treatment for children. An objective ‘best interests’ test in itself, cannot take into account the myriad of human liberties engaged with in end-of-life decision making processes. I argue that such disputes should not be heard before the Courts. I advocate for a multi-disciplinary mediation process to be formally introduced within all medical settings. Such decision-making processes would ensure a fairer weighting of competing interests and rights between disputing parties. This is crucial in reaching a well-informed decision regarding the continuation of medical care for a terminally ill child.
Firstly, my thesis explores the extent to which determining whether acting in a child’s best interests should be a purely clinical judgement, or a matter of autonomy, faith, and human dignity. Despite the test enshrining several subjective factors to be applied– such as considering the feelings, wishes and background of the child in question – there are no set guidelines as to how much weighting should be given to each factor. This in turn has led to an inconsistent body of case law. It has become difficult to determine the extent to which a certain factor influenced the Court’s final judgement. I argue that greater consideration of the individual liberties of the patients and their families involved in such disputes should dictate ethical decision-making processes.
The seminal cases of children such as Charlie Gard, Alfie Evans, and Tafida Raqeeb, demonstrate that improved communication is necessary between patients and medical professionals in such disputes. The breakdown of communication between conflicting parties has been sensationalised within the media. In turn this has caused great misconceptions into the seemingly authoritative role of the medical professionals involved in end-of-life decision-making processes. Furthermore, the lengthy legal battles that certain families have endured is an unintended consequence of the lack of adequate communication avenues outside of the legal realm. Therefore, I will re-examine dispute resolution systems within the medical context, to achieve greater transparency in reaching final decisions. What must remain of paramount importance in these systems, is the respect for individual and parental autonomy.