Alder Hey Children's NHS Foundation Trust v D & Ors

Facts

C is a 14 year old boy who, in February 2022 aged 13, fell ill shortly after recovering from Covid 19. He developed a rash, was admitted to his local hospital on 27 February and was given a working diagnosis of Steven-Johnson Syndrome and then of Toxic Epidermal Necrolysis, confirmed by skin biopsy after transfer to a major teaching hospital; some 90% of his body surface was affected. He was ventilated on 5 March 2022 and has remained ventilated, two attempts at extubation having failed. He suffered septicaemia, multiorgan failure, suspected seizures, Posterior Reversible Encephalopathy Syndrome, severe generalised polyneuropathy and an inability to tolerate enteral feeding, becoming dependent on total parenteral nutrition and remaining in paediatric intensive care. The Trust's clinical ethics committee concluded in November 2022 that continued life-sustaining treatment was not ethically acceptable, and a best interests meeting followed in December 2022. C's mother and the Children's Guardian supported withdrawal; C's father opposed it. Proceedings were issued on 16 January 2023 and the Trust sought declarations that compassionate extubation, standard cares and palliative care were lawful and in C's best interests. The father sought, in the alternative, an adjournment for independent second opinion evidence.