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Ending life support: who decides?

Ending life support: who decides?

A 12-year-old boy was declared legally dead by a judge, who ruled that he should be taken off life support. His mother, Hollie Dance, will fight that decision in the Court of Appeal.

“I’m disgusted, to be honest… Absolutely hell watching my other children hear over and over again by the hospital trust that my child’s already dead.”

Hollie Dance, Sky News

This is Hollie Dance.

She’s a mother from Southend in Essex, and she’s fighting for her son, Archie Battersbee. You might have heard about his case.

“Just nine weeks ago, Archie Battersbee was an energetic 12-year-old, a talented boxer and gymnast. He was happy and surrounded by the love of his family. But now after a tragic accident, that family is dealing with a judge’s decision that their son is dead.”

ITV News

Hollie Dance came home on the 7th April to find her son unconscious, with a ligature over his head.

She believes he might have been taking part in an online challenge. 

The boy’s injuries were severe. He was transferred to the Royal London Hospital, where he was found to have devastating brain damage. 

He’s been in an induced coma ever since. 

“For the last two months, Archie’s mum has not left his bedside here at the Royal London Hospital, holding onto the hope that her little boy will live even a fragment of the life that he used to.”

ITV News

Doctors say the boy’s brain stem – which is responsible for regulating the body’s automatic functions like heartbeats and breathing – is 50 per cent damaged. They also say that 10-20 per cent of his brain stem cells have died or are dying.

They think he should be taken off life support.

Hollie Dance says her son is alive.

“He’s held my hand. He’s partly opened his eyes, you know, his blood pressure changes when, um… Like his little friend was at the hospital visiting him the other day, his blood pressure changed every time he went around and stroked his face. And then he went back on the other side of the bed and it dropped back to where it is.”

Hollie Dance, GB News

On the 13th June, a High Court judge declared Archie Battersbee dead. 

Mrs Justice Arbuthnot provided a written ruling. We’ve voiced up parts of her statement…

“I find that Archie died at noon on May 31 2022. I find that irreversible cessation of brain stem function has been conclusively established. I give permission to the medical professionals at the Royal London Hospital to cease to ventilate mechanically Archie Battersbee. If Archie remains on mechanical ventilation, the likely outcome for him is sudden death and the prospects of recovery are nil.” 

Mrs Justice Arbuthnot

At the heart of this story is a question about what it means to be alive.

In the UK, there is no legal definition of death, or how to determine it. That’s what made the judge’s decision so tricky.

In order to declare someone dead, doctors will refer to a code of practice that was developed by the Academy of Royal Medical Colleges.

This document says that a patient has died when their heartbeat and breathing have stopped, or when it is clear that brain stem function is irreversibly damaged. 

“It’s not a legal way to pronounce somebody dead… it’s an MRI.”

Hollie Dance, GB News

his is where Archie Battersbee’s case is unique.

Normally, when doctors test to see if a patient is alive, they carry out a brain stem test. 

In his case, doctors weren’t able to do that because they suspected the boy had a spinal injury that could lead to false negative results. So they conducted an MRI scan instead. 

That scan showed no blood flow in any vessels of the brain. This is how Justice Arbuthnot ended her statement. 

“He has no pleasure in life and his brain damage is irrecoverable. His position is not going to improve. The downside of such a hurried death is the inability of his loving and beloved family to say goodbye.

Mrs Justice Arbuthnot

But Hollie Dance is not willing to give up. 

In 2021, there was a similar case of an 18-year-old boy called Lewis Roberts. He was declared brain stem dead after being hit by a van.

Just hours before his organs were donated, he began breathing on his own. 

Archie Battersbee’s mother says it is too soon to turn off his life support. 

“His heart is still beating. He has gripped my hand and as his mother and my gut instinct, I know my son is still there. Until it’s God’s way, I won’t accept he should go.

ITV News

His family have won the right to appeal the judge’s decision. 

Their lawyer will argue that, until Archie’s entire brain stem is dead, he is still alive. 

They’re also calling for a criminal standard of liability. In other words – saying that it is likely that Archie is dead isn’t enough.

Here’s journalist Brian Farmer speaking at a recent Tortoise event.  

“It’s going to the Court of Appeal on one issue, and that’s to do with the test that the judge applies so the normal rule in a criminal court is that you have to be beyond reasonable doubt… the normal test in a civil court is done on the balance of probabilities. What Archie’s parents say is that a judge shouldn’t decide that their child is dead, brain stem dead, on the balance of probability she should be sure.”

Brian Farmer, Tortoise

They want doctors to be able to prove he is dead beyond reasonable doubt.

“So it’s going to the Court of Appeal because that question has never been considered by the Court of Appeal before… strikes me as a question that a lot of parents probably agree with…”

Brian Farmer, Tortoise

This means the outcome of Archie’s case could change the legal precedent for how deaths are declared in the UK.  

Until then, Hollie Dance will keep on fighting.

“This hospital’s got the biggest battle ever, because I refused to give up a fight for my son’s life.”

Hollie Dance, ITV News

Today’s episode was written by Patricia Clarke and mixed by Imy Harper.