BRITAIN: A London court has given doctors who are treating a terminally ill baby permission to withhold life-saving treatment by mechanical ventilation if his condition deteriorates - the second such decision in recent days.
However, following a last-minute concession by the hospitals looking after nine-month-old Luke Winston-Jones, he will still have the chance of cardiac massage, if it becomes necessary.
Lawyers for his mother, Ruth, who still hopes he will come home, said later that Luke, who suffers from Edwards syndrome, a rare genetic disorder, had been given "a fighting chance".
Dame Elizabeth Butler-Sloss, president of the High Court family division, asked that there should now be an end to the "conflict" between mother and doctors in what she described as "this truly sad case". She urged Luke's mother to accept the clinical judgment of the doctors. Ms Winston-Jones wept as the judge added: "I very much hope that she and Luke will have the longest possible peaceful and happy period together and that her view that he has as much for the future as he had in the past will be realised."
Ms Winston-Jones (35), from Holyhead, north Wales, accepted in court yesterday that her nine-month-old son was terminally ill. She insisted however that he was "a fighter" who should be allowed to fight on, as she believed "the best was yet to come". She was anxious that Luke should not suffer pain and distress, but felt that the medical profession was giving up on him too soon.
She challenged the view of doctors that Luke's condition was seriously deteriorating and, if it became critical, it would "not be in his best interests" to resuscitate him through cardiac massage or mechanical ventilation.
The judge was asked by the Royal Liverpool Children's NHS Trust and North West Wales NHS for a declaration on what treatment was required and what should be withheld in the absence of agreement between doctors and his mother.
After a tense two-day hearing during which the mother was often reduced to tears, the judge ruled that mechanical ventilation, an aggressive procedure, would not be in Luke's best interests and carried risks that he could become ventilator dependent and his life become "not worth living". However, following a late concession by the trusts, she said cardiac massage should remain an option.
Dame Elizabeth indicated that she had taken into account the approach adopted by the judge who recently gave doctors permission not to ventilate premature baby Charlotte Wyatt if her breathing stopped. Charlotte reached her first birthday on Thursday.
She described how Luke had multiple heart defects, chronic respiratory failure, severe developmental delay, epilepsy and problems in feeding. Few such babies survive beyond a year. Luke had suffered two cardiac arrests and many respiratory arrests during his time in hospital at Bangor and at Alder Hey, Liverpool.
The judge said the mother clearly had a close relationship with Luke "who, despite all his medical problems, responds to her, lies happily in her arms while she cuddles him and goes peacefully to sleep". Referring to Luke's "best interests", she said there was a strong presumption in favour of preserving life, but not if the treatment would be futile.
The court heard that Ms Winston-Jones had agreed a palliative care plan aimed at allowing Luke to return home and had been training in heart massage and resuscitation techniques.