Re Wyatt [2006] EWHC Family Div 04C01788

This case reflects the decision of the Court in the most recent of the 5 judgments made in respect of Charlotte Wyatt (C ) a child aged 2 and a half years old, born with severe brain damage, respiratory difficulties and poor kidney function.  The return to Court was as a result of deterioration in C’s condition and a request by her doctor (K).  C had developed an intermittent rasping cough and it was believed she was suffering from an aggressive viral infection.  Medical staff were unaware of the precise virus and due to the nature of most viruses, were unable to provide any specific clinical remedy.  The only treatment was “to allow the natural body defences to work.”  C was receiving Continuous Positive Airway Pressure  (CPAP –  a method for keeping an airway open in order for oxygen to be administered and to ease breathing). It was unclear to C’s doctor whether this assistance was contributing to any changes in her condition.  He felt that C was still in a “downward trajectory” and that a continued deterioration in C’s condition would mean that CPAP would be insufficient to maintain her breathing.  If such were to occur, the only intervention left open to the medical staff would be that of intubation and ventilation.  In K’s opinion, such intervention would not be in C’s best interests since it would be futile and inflict unnecessary suffering.

C’s parents continued to be consulted throughout the decisions relating to C, although her mother was of the opinion that she would recover if intubated.  This was contrary to the unanimous medical opinion which considered that ventilation would not improve C’s condition and that she was unlikely to survive it.   The Court agreed with the medical opinion and could not see how intubation and futile treatment could be in C’s best interests.  Therefore, the Court held that it would be lawful for the treating medical professionals to refrain from intubating and ventilating C should her condition deteriorate.  This was permissive and not a mandatory order.  At the moment the decision arose, the medical professionals were to use their best professional judgement to determine what was in C’s best interests.

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