Opinion

British injustice

July 30, 2017

Charlie Gard never had a chance. Not only because he suffered from an extremely rare genetic condition causing progressive brain damage and muscle weakness. His condition was half the problem. That the law prevented him from seeking treatment - though it was a slim chance, might have worked or at least extended his life - was part two of the issue. As a consequence, Charlie died on Friday one week before his first birthday but not before generating so much controversy across the world that maybe the laws that did not help him survive will someday change.

Shortly after his birth, Charlie was diagnosed with mitochondrial DNA depletion syndrome, a rare inherited condition that causes muscle weakness and loss of motor skills.

When Charlie’s medical team, with second opinions from several leading centers, decided that his brain damage was irreversible, they believed there was nothing that could help him. The baby’s family felt otherwise. His parents wanted him to be taken to the US for legal treatment. But they were forced to fight a lengthy legal battle with Charlie’s hospital, Great Ormond Street, to allow such a move.

When the two sides reached a stalemate, they had to apply to the courts.

A succession of judges ruled it was in Charlie’s best interests not to go to the US because he may be suffering and the proposed experimental treatment in the US was “futile”.

The court ruling came after a 10-month legal battle that saw Charlie’s parents lose cases in the High Court, the Court of Appeal and the Supreme Court.

Many are questioning why Charlie’s parents were not granted their wish to explore every option, even if the chances of improvement were slim. In most countries, a patient can leave a hospital whenever he or she wishes, even if their departure puts their life in danger.

Same for the courts. In Charlie’s case, why should the law be allowed to interfere in a decision that is strictly and obviously a matter between the parents and their baby?

If Charlie’s plight was the result of the UK having a state-run national health service, that is a weak excuse for his death. Even if one’s government treats a citizen for free, that does not give that government-run hospital or the court the right to decide what is best for the patient, especially if the patient or his guardians have other options.

And Charlie’s parents had. They were buoyed by support from an American neurologist, Prof Michio Hirano, who has pioneered an experimental treatment, a powder called nucleoside therapy. The treatment used as part of Hirano’s research had only been used on a couple of patients with a less severe form of the disorder. But Hirano testified that there was an 11 percent to 56 percent chance Charlie could show clinically significant improvement if treated.

In February, though, the hospital decided, based on Charlie’s status, that treatment was unlikely to benefit the baby.

That is the crux of the problem. Hirano, of New York’s esteemed Columbia University Medical Center who specializes in myopathies and other neuromuscular diseases, gave Charlie and his parents some hope while the baby’s hospital gave them no hope.

Great Ormond Street, one of the world’s most renowned children’s hospitals, said it would be giving careful thought to what it could learn from the “bruising” court case. If Great Ormond Street is to learn anything from Charlie’s story, it must begin by acknowledging that while it might be morally wrong to claim that the hospital and the UK courts let Charlie die, it does not look like they helped him survive.


July 30, 2017
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