In Re B (A Minor) (Wardship: Medical Treatment): CA 1981

The child was born with Down’s Syndrome and an intestinal blockage. She needed the obstruction to be relieved if she was to survive. If the operation were performed, the child might die within a few months but it was probable that her life expectancy would be 20-30 years. Her parents, having decided that it would be kinder to allow her to die rather than live as a physically and mentally disabled person, refused to consent to the operation. The local authority made the child a ward of court and, when a surgeon decided that the wishes of the parents should be respected, they sought an order authorising the operation to be performed by other named surgeons.
Held: The appeal was allowed. The question for the court was whether it was in the best interests of the child that she should have the operation and not whether the wishes of the parents should be respected. The evidence disclosed that if the operation was performed the child would live the normal span of life of a mongol.
Dunn LJ said: ‘I have great sympathy for the parents in the agonising decision to which they came. As they put it themselves, ‘God or nature has given the child a way out’. But the child now being a ward of court, although due weight must be given to the decision of the parents which everybody accepts was an entirely responsible one, doing what they considered was best, the fact of the matter is that this court now has to make the decision. It cannot hide behind the decision of the parents or the decision of the doctors; and in making the decision this court’s first and paramount consideration is the welfare of this unhappy little baby.’
Templeman LJ said: ‘On behalf of the parents Mr Gray has submitted very movingly . . that this is a case where nature has made its own arrangements to terminate a life which would not be fruitful and nature should not be interfered with. He has also submitted that in this kind of decision the views of responsible and caring parents, as these are, should be respected, and that their decision that it is better for the child to be allowed to die should be respected. Fortunately or unfortunately, in this particular case the decision no longer lies with the parents or with the doctors, but lies with the court. It is a decision which of course must be taken in the light of the evidence and views expressed by the parents and the doctors, but at the end of the day it devolves on this court in this particular instance to decide whether the life of this child is demonstrably going to be so awful that in effect the child must be condemned to die, or whether the life of this child is still so imponderable that it would be wrong for her to be condemned to die. ‘
References: [1990] 3 All ER 927, [1981] 1 WLR 1424
Judges: Templeman LJ, Dunn LJ
Jurisdiction: England and Wales
This case is cited by:

  • Cited – Airedale NHS Trust v Bland FD 19-Nov-1992
    The patient had suffered catastrophic injuries in 1989, leaving him in a persistent vegetative state (PVS). The doctors sought leave to discontinue life maintaining treatment and medical support. The inevitable result would be his death. The . .
    (, [1993] 2 WLR 316)
  • Cited – Airedale NHS Trust v Bland CA 9-Dec-1992
    The official Solicitor appealed against a decision that doctors could withdraw medical treatment including artificial nutrition, from a patient in persistent vegetative state.
    Held: The doctors sought permission to act in accordance with . .
    (, [1993] 2 WLR 316)
  • Considered – In re J (a Minor) (Wardship: Medical treatment) CA 1-Oct-1990
    J was born at 27 weeks’, weighing only 1.1kg. He suffered very severe and permanent brain damage at the time of his birth, the brain tissue then lost being irreplaceable. He was epileptic and the medical evidence was that he was likely to develop . .
    ((1991) Fam 33, [1990] 3 All ER 930, [1991] 2 WLR 140, Times 03-Oct-90, [1992] 1 FLR)
  • Cited – An Hospital NHS Trust v S (By her Litigation Friend the Official Solicitor) And D G (S’s Father) and S G (S’s Mother) FD 6-Mar-2003
    The hospital sought a declaration that it had no obligation to provide a kidney transplant to an eighteen year old youth who had had very severe disabilities since birth. It was argued that his mental condition meant that he would be unable to cope . .
    (, [2003] EWHC 365 (Fam))
  • Cited – In Re A (Minors) (Conjoined Twins: Medical Treatment); aka In re A (Children) (Conjoined Twins: Surgical Separation) CA 22-Sep-2000
    Twins were conjoined (Siamese). Medically, both could not survive, and one was dependent upon the vital organs of the other. Doctors applied for permission to separate the twins which would be followed by the inevitable death of one of them. The . .
    (Times 10-Oct-00, , [2000] EWCA Civ 254, [2001] 1 FLR 267, [2000] 4 All ER 961, [2001] Fam 147, [2001] 2 WLR 480, [2001] 9 BHRC 261, [2000] 3 FCR 577, [2001] Fam Law 18, (2001) 57 BMLR 1, [2000] Lloyd’s Rep Med 425, [2001] UKHRR 1)
  • Cited – Wyatt and Another v Portsmouth Hospital NHS and Another CA 12-Oct-2005
    The appellants’ daughter had been born with very severe disabilities. Her doctors obtained an order allowing them a discretion not to ventilate her to keep her alive if necessary. She had improved, but the family now sought leave to appeal an order . .
    (, [2005] EWCA Civ 1181, [2005] 1 WLR 3995)
  • Applied – In re J (a Minor) (Wardship: Medical Treatment) CA 1986
    The court referred to a case of extremely painful treatment causing continuous agony or such continuous sedation as to lead to there being no conscious life at all. The child suffered a condition which included the likelihood of periodic respiratory . .
    ([1991] Fam 33, [1990] 3 All ER 930, [1991] 2 WLR 140)
  • Cited – In re T (a Minor) CA 24-Oct-1996
    C was born with a liver defect. After a failed operation, the parents, both caring health professionals, decided not to put him through major surgery again. The local authority and doctors obtained an order to allow a potentially life saving liver . .
    ([1997] 1 WLR 242, , [1996] EWCA Civ 805)
  • Cited – Aintree University Hospitals NHS Foundation Trust v James SC 30-Oct-2013
    The hospital where a gravely ill man had been treated had asked for a declaration that it would be in his best interests to withhold certain life-sustaining treatments from him. When can it be in the best interests of a living patient to withhold . .
    (, [2013] UKSC 67, [2014] 1 All ER 573, [2014] Med LR 1, [2014] 1 AC 591, (2014) 135 BMLR 1, [2013] BUS LR 1199, [2013] WLR(D) 421, [2014] 1 FCR 153, [2013] 3 WLR 1299, (2013) 16 CCL Rep 554, , , UKSC 2013/0134, , )
  • Cited – Nicklinson and Another, Regina (on The Application of) SC 25-Jun-2014
    The court was asked: ‘whether the present state of the law of England and Wales relating to assisting suicide infringes the European Convention on Human Rights, and whether the code published by the Director of Public Prosecutions relating to . .
    (36 BHRC 465, [2015] 1 AC 657, 139 BMLR 1, [2014] WLR(D) 298, [2014] 3 FCR 1, [2014] HRLR 17, [2014] 3 WLR 200, [2014] 3 All ER 843, (2014) 139 BMLR 1, , UKSC 2013/0235, , , , , [2014] UKSC 38, [2014] 3 WLR 200)

These lists may be incomplete.
Last Update: 27 November 2020; Ref: scu.211400

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