End-of-life

Alfie Evans: no human life can be considered “futile”

Usually, the term “futility” is used to define medical treatment according to its effectiveness in given clinical conditions. Yet, how can judges define a human life “futile”? According to which criteria? Furthermore, how can this judgement – that makes the difference between life and death – be applied to a two-year toddler who is unable to reply or oppose such decision?

The sad case of Alfie Evans (23 months–old) deserves further reflection and in-depth debate. The English toddler from Liverpool is unfortunately affected by a progressive neuro-degenerative condition that doctors have not been able to definitively identify (also in terms of administrating the appropriate treatment), with a very poor prognosis that left him in a semi-vegetative state. Alfie presently needs artificial ventilation as well as enteral nutrition and hydration. The doctors of the Alder Hey Children’s Hospital, where the child is hospitalized, said there is no prospect of recovery and believe it is in Alfie Evans’ best interests to remove his life-support treatment, thereby causing the child’s death (obviously after having been sedated). But

Alfie’s parents, Thomas and Kate, fought against this decision, making it necessary to undertake a legal battle to resolve the conflict of opinions. Unfortunately, the Court of Appeal upheld the conclusion ruling that the doctors’ decision (interrupting life-support treatment) is legitimate and is the best option for Alfie himself.

But the element that further upset many of those following this issue was the lower Court justices’ motivation for their ruling. In fact they defined the life of Alfie “futile”, and since “futile” means pointless, to no purpose, with no prospects, it deserves ending in death. Usually, the term “futility” is used to describe medical treatment according to its effectiveness in given clinical conditions. Yet, how can judges define a human life “futile”? According to which criteria? Furthermore, how can this judgement – that makes the difference between life and death – be applied to a two-year toddler who is unable to reply or oppose such decision? 
On top of that, Alfie’s parents are strenuously petitioning for and appealing to be given the possibility to transfer Alfie to another hospital (Bambino Gesù children’s hospital in Rome has offered to admit the child and treat him), receiving the solidarity of Pope Francis. But the judges are denying also this possibility, thereby effectuating a “legalized imprisonment” of Alfie, legally bound to remain in the Alder Hey Children’s Hospital – at least for now.
 We wonder whether

a modern democratic State, by means of its legal judgements, can interfere in a family’s life and decisions to such an extent.

And, most of all, can it do so be deciding someone’s right to live or to die? including a toddler incapable of deciding for himself? To be honest, all this appears utterly incomprehensible and gravely inhumane! The only interpretation that can explain similar regulatory and court decisions is a cultural horizon that decides to give prominence to death as opposed to life, especially with regard to “fragile” individuals, who presumably represent, in one way or another , a social burden for the State. A sad principle which – at a dispassionate analysis – in order to prevent future “rifts”, in this case is applied even in spite of the evidence, given that all that Alfie’s parents are asking is to take care of their child, taking on full responsibility, including medical costs.
Is this what we want for us and for our children’s future? If the answer is No, there is an urgent need to join forces to spread the culture of neighbourliness, of solidarity, of “caring”, throughout our communities, especially with regard to the weakest and fragile members of society. So that no human life may ever be defined “futile”, and thus be discarded!