„Please allow Alfie Evans to be healed in another country if in UK this is not posible and his parrents consider that is better for Alfie to go in Italy
>>I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion<< – Hippocratic oath

Regards”

Răspunsul lor, este următorul:

”Dear Mr Mihai

We were all very sad to read in the news about Alfie’s passing on Friday night. This has been a tragic and challenging case for all those involved.

It may be helpful if I say something about the role of the GMC in giving guidance to doctors on ethics and professional standards, before outlining the guidance we give to doctors who are caring for children and young people.

The purpose of our guidance is to describe what good practice looks like, by setting out the professional values, knowledge, skills and behaviours expected of all doctors working in the UK. We do this in our core guidance Good medical practice and the explanatory guidance that can be found on our website here: http://www.gmc-uk.org/guidance/index.asp

We provide specific guidance on the treatment and care of children who do not have capacity to make their own decisions in our guidance 0-18 years guidance for all doctors. We also provide specific guidance on end of life care in Treatment and care towards the end of life.

A core principle in our guidance about the treatment and care of children and young people is that doctors must always act in the best interests of the child. In doing this, they must take into account:

The views of parents, and others close to the child or young person

Up to date, authoritative clinical evidence and relevant guidance on what may be appropriate treatment options

The views of healthcare professionals involved in providing care to the child, and any other professionals who have an interest in their welfare

Any other factors relevant to the circumstances of the individual child, including non-medical factors.

Identifying a child’s best interests is not always easy, and there may be conflicting views that are difficult to reconcile. In any situation where the clinical picture is complex and challenging, we know that it can be very difficult to judge when the burdens and risks of a particular treatment, including the degree of suffering that may be caused by treatment, will outweigh the potential benefits of the treatment to the patient. Making these judgements can be particularly challenging where treatments are untested and the patient is a very young child with a life-threatening condition.

Our guidance therefore sets out the established legal and ethical framework that doctors should work within. Doctors should always try to work in partnership with parents to try to reach a shared view about the best course of action. Where there is significant disagreement, and this can’t be resolved between the medical team and family, then we say that it may be necessary to seek an independent review by the courts. Approaching the court should be seen as a constructive way of thoroughly exploring the issues and providing reassurance that the child’s interests have been properly considered in the decision.

Whilst we absolutely recognise how distressing this case is, it is not for the GMC to intervene or to comment on the specifics of it, beyond highlighting the guidance we provide to doctors on caring for children at the end of their lives. It is ultimately for the courts to make the decision about the best interests of the child in complex and challenging cases such as this.

Where doctors are following the principles of our guidance we would have no cause to take action.

Yours sincerely

Dr Colin Melville

Director of Education and Standards”

Pare că sunt sufocați și ei de proceduri la fel ca noi toți cei ce avem de a face cu mediul social tot mai instituționalizat și reglementat.