Tragic choices in health care: lessons from the Child B case

Four years ago the case of Jaymee Bowen, more commonly known as Child B, captured the newspaper headlines. The coming together of a father who was determined to seek the treatment he believed was best for his daughter, doctors who disagreed about what treatment was appropriate, health service managers who were prepared to take a stand on the use of resources on services of questionable effectiveness, lawyers willing to test the decision of the health authority in the courts, and journalists who saw the case as exemplifying the dilemmas of health service decision making meant that Jaymee's story caught the public imagination and highlighted the challenge of rationing.1 The way in which the case was handled contains important lessons for decision makers in health authorities and primary care groups charged with making difficult choices in health care.