The world was transfixed over the last week by the tragic case of Alfie Evans. This poor young boy, not yet two years old, was the center of a legal dispute in which his life hung in the balance. His case has a greater significance, though, because it is a demonstration of how bad law can kill
A quick synopsis of the basic facts of Alfie's case will help put us understand this bigger picture. Not long after he was born, he started showing symptoms of a neurological disorder and had to be hospitalized. The condition was never diagnosed, but it progressed and left Alfie in a coma and dependent on assisted food, hydration and breathing. After over a year of treatment, the doctors decided that further treatment of Alfie was futile and that his recovery was impossible. I am sure that they made that diagnosis in good faith. But his parents disagreed, and searched out other options for continued treatment or, failing that, they wanted to bring Alfie home
Here is where the bad law makes its appearance. In the UK, the law gives the court authority to overrule parental decisions if there is a dispute between the doctors and parents over life-sustaining treatment for their child, based on his assessment of the "best interests of the child". And that's what happened here. The court overruled the parents and gave permission to the doctors to remove Alfie from life support
So without any proof of abuse or neglect or any other misconduct on the part of Alfie's parents — in fact, all the evidence was that they were devoted to him — their parental rights were stripped from them simply because they disagreed with the doctors about how to care for their son. The court actually went even further, and forbade Alfie's parents from choosing any other kind of treatment, and even forbade them from taking him home. This is an astonishing result. Alfie had the right to have his care decided upon by his parents, not by doctors or judges. I can only describe this as judicial kidnapping
As bad as that law is, the underlying principles are even worse. The initial court that ruled on Alfie's case gave great authority to a document called "Making Decisions to Limit Treatment in Life-limiting and Life-Threatening Conditions in Children: A Framework for Practice", issued by the Royal College of Paedriatics and Child Health in 2015. This "guidance" sets out the standards under which medical decisions will be made for critically ill children who are dependent on "life-sustaining treatment". In that document, there are two fatal errors that inevitably distort the way that doctors will approach the care of children on life support, and that create a significant bias in favor of death
The first error is this astounding statement: "The principle of the sanctity of life is not absolute." All the errors in Alfie's case, and all those like it, stem from this tainted source. If the sanctity of life isn't absolute, then of course courts and doctors will put conditions on preserving it. When that decision is made in the context of our society's fear and even disgust for disability and diminished capacity, this guarantees that imperfect lives will be systematically devalued and discarded. And that's exactly the calculus that the court was making, applying the principle set out elsewhere in the document that life-sustaining treatement can be ended "when life is limited in quality". Operating from these premises, it makes perfect sense that a misguided court will reach the horrific conclusion that a patient like Alfie is better off dead
This is the evil doctrine of "lives unworthy of living", the wicked notion that "It can in no way be doubted that there are living human beings whose death would be a deliverance both for themselves and society, and especially for the state, which would be liberated from a burden that fulfills absolutely no purpose". This discredited principle from the infamous 1923 book Permitting the Destruction of Life Not Worthy of Life , which led to the involuntary euthanasia program of the Nazis, keeps coming back under different guises. Pope Francis called it by another name: "the throwaway culture"
Along with this fatal flaw comes the second error, which can be found in this key definition: "Life-Sustaining Treatments (LSTs) are those that have the potential to prolong life. They may include… Clinically Assisted Nutrition and Hydration". Considering assisted nutrition and hydration as "treatment" is very common in the medical world. But it is utterly misguided
Food and water are not medical treatments but basic human needs, like shelter, clothing, air and sanitation. They are fundamental human rights, and caregivers have an obligation to provide them if a person can't do so for themselves. This stems from their inherent dignity as a human person, which is never lost because of condition or prognosis. This is a foundational perspective of sound medical morality. By rejecting this norm, the UK doctors ensured that some of their patients, whose lives are no longer considered worth preserving because of a negative prognosis, will be killed by starvation or dehydration
These distorted principles produced the regime of law that killed Alfie Evans and betrayed his parents: a law that permitted a judge to substitute himself for Alfie's parents; an underlying bias against the value of life with a disability; and an erroneous notion that a fundamental human need can be denied if the overall prognosis is bad. All of that adds up to a law that leans in favor of death.
We are dangerously close to following it here. It's true that our Supreme Court long ago recognized the natural law principle that "the child is not the mere creature of the State" and that parents have the authority to oversee their health and upbringing. But we have already seen courts and laws interfere with that sacred family relationship. For example, children can get contraceptives and even abortions without their parents even being notified. That is a dangerous path, and it is even more treacherous when combined with trends in the medical world like increasing approval of assisted suicide and euthanasia, futile care theory, cost pressures, and the invidious social fear and disdain for disability. It leads inexorably to euthanasia, the fancy word for murder by doctor
The Alfie Evans case is a test study for how the law can kill. This is why we cannot give an inch in our resistance to assisted suicide and euthanasia, and why we can never surrender to the Culture of Death.