ABSTRACT
Chapter 6 examines the body of case law concerned with decisions to withhold or withdraw life-sustaining treatment from children. In this chapter it is argued that it is important to understand the case law within the prevailing social and political context within which the decisions are made. Whilst the early cases are examples of judgements about the limited quality of life for people with disabilities, attitudes have changed, such that in the recent cases, the range of treatment options have been fully explored by the child’s treating doctors before the application to court for a decision of whether it is in the best interests of the child to withhold or withdraw life-sustaining treatment. In most of the more recent cases, the question of withdrawing life-sustaining treatment has only been brought before the court once the treating team have reached the conclusion that, in their professional judgement, there is no further treatment that can improve the child’s condition, a situation in which the burdens of continued life-support outweigh the benefits it offers to the child who is not able to interact with his or her family. It argues that determination of the child’s best interests has to be placed within the context of the legal and professional duties of doctors as well as parental responsibility. By giving separate consideration to professional duties alongside best interests, the medical evidence as to the choices available would be clear, from which the decision is made as to the course of action that is in the best interests of the child. That would ensure that the courts critically evaluate the medical evidence informing the best interests analysis and more effectively fulfil their public responsibilities to protect the interests of children.
