The alfie challenge – page 3 – pprune forums wisdom tooth extraction pain relief

Court of Appeal second judgement (16th April)But it’s worth noting that the hospital trust was the only mechanism available to represent the medical team. The central NHS itself wasn’t, as far as I’m aware, involved in any legal action, just the managers of the medical team who instructed their legal people. If Alder Hey was run by one of the medical insurance companies, then it would be their name on the legal papers, but again would almost certainly not relate back to the central insurer, just the managers of that particular hospital that instructed their legal team.

For those not familiar with the way the NHS works here, it’s broadly similar to the US system in a few ways, in that hospitals and other health care providers run semi-autonomously, usually as Trusts, and charge the NHS for their services.


The NHS itself is vaguely equivalent to all the main health care insurers, Medicare etc, rolled into one single funding body, that buys medication, medical products etc from pharmaceutical and medical supply, companies at supposedly reduced prices (because of the volume pricing model) and also buys services from hospital trusts, many forms of primary healthcare providers (independently run and managed general practices, dental practices and opticians) and also private sector health care providers on occasion. Some have likened the model to playing shopkeepers, which is a pretty close analogy, I think.

The idea is that each provider is operating within a market to some extent, with the objective (which I happen to think is flawed) of trying to get competition to drive down costs. The reality seems to be that hospital and health care trusts have become dominated by managers who seem to game the system at any and every opportunity, and I don’t believe that the splitting off of hospitals etc from the centrally run NHS has worked to reduce costs at all.

What is obvious is that the grief of this child’s parents has been hijacked for their own ends by fundamentalist religious nutters (including the Pope). Their interventions have been inflammatory, disgraceful and ultimately absolutely unhelpful, have merely stoked a media shitstorm, and have resulted in medical staff, parents and even patients being intimidated and terrified by knuckle dragging imbeciles.

Meanwhile, the doctors and the various judges involved have only been concerned with one thing: what was best for a desperately (terminally) ill child. Of course, in the vast majority of cases parents can (and must) make all necessary decisions for a child unable to make those decisions for themselves. The courts do not want to interfere, and will only do so when there is a clear indication that they must do so to prevent undue suffering.

To respond to the OP: I’d say that the reasoned, measured and sensitive approach taken by the various courts is very much indicative of a civilised and enlightened society. If people want to place their trust in invisible sky pixies and believe in fairy tales, that is a matter for them, but such beliefs cannot be permitted to cause harm to children.

What is obvious is that the grief of this child’s parents has been hijacked for their own ends by fundamentalist religious nutters (including the Pope). Their interventions have been inflammatory, disgraceful and ultimately absolutely unhelpful, have merely stoked a media shitstorm, and have resulted in medical staff, parents and even patients being intimidated and terrified by knuckle dragging imbeciles.

Meanwhile, the doctors and the various judges involved have only been concerned with one thing: what was best for a desperately (terminally) ill child. Of course, in the vast majority of cases parents can (and must) make all necessary decisions for a child unable to make those decisions for themselves. The courts do not want to interfere, and will only do so when there is a clear indication that they must do so to prevent undue suffering.

To respond to the OP: I’d say that the reasoned, measured and sensitive approach taken by the various courts is very much indicative of a civilised and enlightened society. If people want to place their trust in invisible sky pixies and believe in fairy tales, that is a matter for them, but such beliefs cannot be permitted to cause harm to children.

I wholeheartedly agree, and reading through the legal judgements kindly posted by DaveReidUK made it very clear as to what the poor child’s medical condition was, not in the eyes of just one doctor, but by every member of every medical team that examined him. These quotes, from the judgements, summed up how hopeless this poor child’s condition was:

The stark nature of the effect of this condition is that an MRI scan undertaken at the beginning of February 2018 revealed, to quote from the Court of Appeal’s previous judgment the almost total destruction of his brain. As Hayden J said in his judgment of 11th April the terrible reality was that almost the entirety of Alfie’s brain (has) been eroded leaving only water and cerebral spinal fluid. By the end of February the connective pathways within the white matter of the brain which facilitate rudimentary sensation – hearing, touch, taste and sight, had been obliterated. They were no longer even identifiable on the MRI scan. The effect of what had occurred was that Alfie’s brain was entirely beyond recovery: February judgment. Further treatment is futile, as all experts agree, both from the United Kingdom and abroad. Alfie’s degenerative condition is remorseless and he will never make any developmental progress. And this quote summed up the dreadful dilemma his father found himself in: