Judge allows boy to have bone marrow transplant against father’s wishes

BMJ 2013; 347 doi: (Published 06 December 2013) Cite this as: BMJ 2013;347:f7344
  1. Clare Dyer
  1. 1BMJ

A High Court judge has given permission for a 3 year old boy to receive a bone marrow transplant against the wishes of his father.

The father initially consented to the procedure at a leading English children’s hospital but withdrew his agreement at the last moment, insisting that the boy, who was called AA in court, be flown back to the unnamed Middle Eastern country where the family lives.

The NHS trust caring for the child, who has spent the past two years at the hospital, had him made a ward of court and then made an emergency application to Mr Justice Mostyn at the High Court in London for permission to undertake the treatment.

A lawyer for the trust told the judge that the boy was in a special sterile room, having had his immune system effectively deleted in preparation for the transplantation. He was in “a perilous state and highly vulnerable,” and the proposed trip would almost certainly kill him, the lawyer said.

AA’s diagnosis has not been specified, but the lawyer added, “He is liable to contract an infection of which he will almost certainly die. The only way to get him out of this situation is to go ahead with the transplant.” The procedure was scheduled for 5 December, the day after the court application.

AA’s father initially supported the transplantation, and the boy’s sister proved an almost perfect match. But the children’s father changed his mind, and AA’s mother, who is estranged from his father, has stepped in to become the donor.

Mostyn is the judge who gave doctors permission in August 2012 to carry out a forced caesarean section on a mentally ill Italian woman who lacked the capacity to consent, in a case that sparked media controversy after the details emerged last weekend.1

Giving his decision in the latest case, he said that there were no facilities for bone marrow transplantation in the family’s country and that “even if there were, he cannot be flown there, as it is highly likely he would contract an infection and die.” He added, “This child is my ward, and I cannot contemplate that.”

The judge said, “The evidence seems to me that the father had, in effect, consented by sending over members of his family to see if they could be matching donors.”

To become a ward of the High Court a child must be habitually resident in the court’s jurisdiction of England and Wales. The judge said that AA fell into this category because he had been living in the hospital since November 2011.

“In my judgment he is habitually resident in this country, and in these circumstances the court has jurisdiction over him.”


Cite this as: BMJ 2013;347:f7344