The British boy who will die twice


Midrar Ali and his parents

The British parents of a brain-damaged four-month-old baby lost a legal battle to keep him on life support earlier this month. A high court judge, Mrs Justice Lieven, ruled in January that Midrar Ali was brain stem dead and doctors at St Mary’s hospital in Manchester could withdraw treatment.

The baby’s parents, Karwan Ali and Shokhan Namiq, appealed her judgement. As Muslims they wanted to struggle to keep him alive and hope for the best.

But on February 14, the court of appeal upheld the earlier ruling. Describing the judgment as “terrible”, the boy’s father told the media: “They can’t be 100% sure he is dead. He’s still growing. His eyes move. I’ve seen them move.”

But so sure were the appeal judges that the child was dead that they concluded that “by 20:01 on 1 October 2019 irreversible brain stem death had occurred and the child was, therefore, clinically dead“. Understandably, the parents were perplexed by this, as their baby has been growing for four months.

(There have been no reports in the media of the child’s death yet.)

“There is no basis for contemplating that any further tests would result in a different outcome,” said Justice McFarlane. “The factual and medical evidence before was more than sufficient to justify the findings.”

The court relied heavily on a description of the child’s condition from a consultant neonatologist:

Midrar is unconscious and has no appreciation or perception of the world around him. I do not believe that he has the capacity to feel pain or distress, so this deterioration will not be distressing for him. It will however, be an undignified and unkind way to allow his death to take place. It will also place a significant burden of distress onto his family and onto those who are caring for him given the futility of these interventions and the associated unkindness."

The child suffered brain damage after being starved of oxygen during a complicated birth. The hospital believes that continuing treatment was undignified, and that Midrar had never breathed without the help of a ventilator. His organs were deteriorating and that he should be allowed a “kind and dignified death”.

The judgement of the appeal court points out that UK courts have accepted the notion of “brain stem death” because “no patient has ever regained consciousness or awareness following brain stem death”. However, the diagnosis of death in America, Canada, Australia and elsewhere is not based upon brain stem death, as it is in the UK, but relates to the wider concept of ‘whole brain death’”.

Michael Cook is editor of BioEdge




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