The story of Ashya King has steadily unfolded since his removal from Southampton General Hospital last Thursday, and has fast become the subject of much debate about the appropriateness of actions of the hospital, local authority, police and family.
That removal triggered a series of events that culminated in a European arrest warrant being issued against his parents on grounds of neglect and their arrest in Spain on Monday. His parents were freed from custody on Tuesday after efforts to extradite the couple to the UK were abandoned and the CPS withdrew the warrant.
In the meantime, the controversial debate as to the actions of the statutory authorities and the rights of individual parents and families continues, including the right to a private and family life.
While the hospital, consultants and police face criticism of their heavy-handed and bureaucratic approach to the Kings’ exercising their parental rights, Aysha’s parents face judgement of their religious beliefs (they are Jehovah’s Witnesses) and allegations of neglect, kidnapping and cruelty. These they vehemently deny. What surely cannot be disputed is that each did what they considered to be in Ashya’s best interests.
It appears that for the hospital and police, events unfolded very quickly with little or no information as to the arrangements Aysha’s parents had made for him. In the absence of this information, if proactive action had not been taken and harm had come to Ashya, would they equally not face criticism for doing nothing? As information has emerged, it is evident that decisions are being re-evaluated. Outside hospital, the power to take steps to safeguard children is with the local authority (social services) and, as here, it can apply to court for interim wardship orders.
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As the law stands, disagreement between healthcare professionals and parents (whose consent must be obtained for treatment to be lawfully provided) is usually resolved by the courts. But, the law also states that doctors are under no legal or ethical obligation to agree to a request for treatment if they do not consider it to be in best interests of their patients. Where does that then leave families such as the Kings? Factor into this mix the right of parents to make decisions as to what they believe to be in their child’s best interests, including a right to pursue alternative medical treatment, a decision that the Kings have had to justify by posting videos on YouTube.
The legal, ethical and moral principles in these situations are complex. Trust, communication and respect for individual beliefs are essential in situations such as this, as are second opinions from independent consultants. Ordinarily, arrangements can be made by agreement (or by involvement of the court) for transfer to alternative centres of excellence for treatment and it is unfortunate for events to have unfolded as they have. While likely to be time-consuming, a measured and considered response can only be in the best interests of all concerned.
Kiran Bhogal is partner and head of the health and social care team at Weightmans and Salma Kantharia is an associate in the health and social care team