Where There is Life, There is Not Always Hope. Ethics, Futility and the Alfie Evans Case

by Dominic Wilkinson


[Updated 22/02/18]

This afternoon, in another case of disputed medical treatment for a seriously ill child, Justice Hayden in the High Court concluded that treatment should be withdrawn from toddler Alfie Evans against the wishes of his parents.

See below for a press release on the Alfie Evans decision. I will add further reports and links to the court transcript when it is available.

See here for ethics commentary and resources on the Charlie Gard case.

See also my recent blog on the Evans and Haastrup cases: Medical treatment disputes and the international second opinion

Details from the court ruling (Liverpool Echo)

Court judgement

Press Release:

Where there is life, there is not always hope.

This afternoon, Justice Hayden, in the High Court in London concluded that continued medical treatment for 21-month old Alfie Evans would not be in his best interests.

The exact cause of Alfie’s condition is not known – there is no diagnosis, which can make it hard to know what the future holds. However, in Alfie’s case, the future, sadly, appears clear. Multiple medical specialists gave evidence in the case. Brain scans have shown severe deterioration over time. The judge described scans showing that large areas of the brain have been “wiped out”. Alfie is totally dependent on life support. He has profound neurological damage. There appears to be no prospect of recovery, and no specialists in this country, or overseas have identified any tests or treatment that have a real chance of making him better.

It is devastating news for any parent to hear that their child is gravely ill.  It is especially difficult in situations when doctors cannot be sure of the exact cause of the child’s illness. However, sadly, despite all of our advances in genetics, it is still sometimes impossible to make an exact diagnosis in a seriously ill child.

It is very understandable for parents to want to hold on to hope, to exhaust every possibility that might make their child better. However, sometimes the sad fact is that medicine cannot cure, or improve a child’s condition. Sometimes the only hope that remains is that a child’s suffering is not prolonged.

The judge’s decision today will be terribly disappointing for Alfie’s family, and for all those who have supported them. However, these decisions are not reached lightly. Doctors do not always agree with parents about what would be best for the child. Yet, doctors only resort to the courts for help in the most extreme of situations, when all other avenues of treatment and of reaching agreement have been lost. Judges in this country have sometimes decided that life support can be stopped for a child, against the wishes of their parents. However, they reach that decision only when there is overwhelming evidence that treatment cannot help a child, and would, in fact do more harm than good.

Justice Hayden recommended that it would now be best for Alfie to receive palliative care. The UK has a reputation for having some of the best palliative care services in the world. There would be no benefit to him travelling overseas, and only risks to Alfie in doing so.

The family might be encouraged by some of their supporters to appeal this court decision as did the family of Charlie Gard. However, based on the experience of other similar legal cases in the UK, there is no prospect of such an appeal being successful. It would merely prolong the agony of Alfie and of his family. It is time to stop fighting, time to let him go.





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3 Responses to Where There is Life, There is Not Always Hope. Ethics, Futility and the Alfie Evans Case


    It is difficult for all involved, I’m sure. The only words that remain for me is acknowledged before the Great One that created little Alfie. Parents and loved ones must take comfort in the fact that God sees and knows all. Whether we have a strong conviction or not, the facts are that we all belong to The One who made us and and as we live however long on this earth, we shall surely return to Him and sometimes sooner than later. My hope is that Alfie’s parents and loved ones will know and be comforted that their son is safe and well where he is. Live a life now that will be worthy of seeing Alfie again and be able to spend time with their son that will never cease. I, too, lost a young son and that is the only hope we have is to know they are in God’s Hands and we will see them again!!! God bless the Evans family.

  • GHP Raju says:

    It’s a testing time for Alfie’s parents. The faith in God they nurtured all these years sure will strengthen them to allow Alfie leave for the heavenly abode. True to their faith, I am also sure, that Alfie’s parents will be happy to know and contended that the money saved from de-medication of Alfie will surely be used to save some other lives on whom the doctors have been attending to.
    Trust the objective judgement of the doctors. Their professional skills tried to save Alfie. But their grieving hearts sure will bless Alfie rest in eternal peace.

  • Marcin says:

    Oh dear poor Aristotle. I hope he is feeling better soon. Sending him some cuddles and some to Alfie, I hope he is recovering well. Actually sending cuddles to all of you. Hope your dad gets to Switzerland okay. xxxxx

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