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Reviving sick baby is futile and cruel, doctors tell court

Maxine Frith,Social Affairs Correspondent
Friday 01 October 2004 00:00 BST

An NHS trust asked a High Court judge yesterday to grant doctors the right to let a severely ill baby girl die in defiance of her parents' wishes.

An NHS trust asked a High Court judge yesterday to grant doctors the right to let a severely ill baby girl die in defiance of her parents' wishes.

Charlotte Wyatt was born three months premature and suffers from profound physical and mental handicaps.

Now 11 months old, she has never left hospital and her doctors believe she is so severely disabled that it is "futile and cruel'' to revive her if she stops breathing.

After resuscitating her for a fifth time in August, they asked her parents, Debbie and Darren, for permission not to revive her if she stops breathing again. But Mr and Mrs Wyatt, who are committed Christians, have insisted they want their daughter treated at all costs and refuse to agree.

Portsmouth Hospitals NHS Trust, which runs St Mary's Hospital where Charlotte is being treated, has now asked the High Court to grant permission. The landmark case raises big issues over the treatment of severely ill babies and doctors' rights to refuse to resuscitate.

The medical team treating Charlotte say she is likely to suffer a relapse within weeks and the High Court ruling is urgently needed to clarify the position.

Mr and Mrs Wyatt say their daughter responds to touch and could lead a tolerable life if she is reventilated in the event of her stopping breathing.

She was born at the hospital on 21 October last year at just 26 weeks. She weighed less than 1lb and was only 5ins long. As a result of her prematurity and subsequent infections, doctors say she is profoundly physically damaged and has suffered permanent and irreversible injury to her brain.

She cannot see or hear, has no control over her movements and has the most extreme form of cerebral palsy. Doctors believe she can only experience pain. She has never smiled and will have to be fed through a tube for the rest of her life as she is unable to digest solids.

According to one expert, she suffers from the most severe case of chronic lung disease doctors have seen and constantly fights for breath. She spends almost every hour of the day with her head encased in a box supplying her with oxygen, without which she would stop breathing and die.

The case has aroused such passions that none of the doctors giving evidence can be identified because of fears they could be targeted by pro-life extremists. One of the experts who had observed Charlotte said: "She has a terrible quality of life dominated by pain and suffering without any joy or fulfilment.

"Any measure that increases the quantity of life can be considered futile and even cruel.'' She will never be able to walk or sit unaided and even if she is resuscitated, one expert said, she had only a 1 per cent chance of surviving for another year.

Doctors say that, every time she stops breathing and is resuscitated, her lungs, heart, kidneys and brain are damaged even more and the ventilation process leaves her in more pain. Her chronic lung disease means she is extremely vulnerable to respiratory infections and doctors believe she is likely to suffer a relapse.

Despite the box encasing her head, she frequently gasps for breath and because she is already receiving maximum oxygen levels, nurses can do little to soothe her or dull the pain.

Opening the case yesterday, David Lock, for the NHS trust said: "This is not a case of either party winning or losing. This case concerns the vexatious issue of the best treatment for what all the experts agree is an extremely ill baby with life limiting conditions.

"Both the consultants and the parents want the best for Charlotte but there is disagreement about what is in her best interests. In cases where, despite many hours of soul searching on all sides, there is no agreement, the court has the unenviable job of deciding what is in the best interests of the child.''

Giving evidence, a consultant paediatrician, known only as Dr E, said: "I have no wish to stop treating Charlotte at all.

"The only issue that I feel strongly about is that should she deteriorate, it is not in her best interests to escalate the treatment such that she should receive ventilation. I think that should be an intolerable thing to do to this poor girl.''

Mr and Mrs Wyatt, from Portsmouth, are adamant that their daughter is improving and could have some quality of life. Mr Wyatt, a chef, said: "If we can keep her going, that is what we want to do, because all the time she is getting stronger.

"They are not going to change our minds about wanting to keep her alive. We cannot believe what the hospital wants to do."

Mr Wyatt is due to give evidence in court today.

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