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Judge rules that boy with brain cancer can be treated in Prague

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5570 (Published 10 September 2014) Cite this as: BMJ 2014;349:g5570
  1. Clare Dyer
  1. 1The BMJ

A 5 year old boy with brain cancer whose parents were arrested and jailed after they took him from a UK hospital without telling doctors can undergo the “entirely reasonable” treatment his parents want for him in Prague, a High Court judge in London has ruled.

Brett and Naghmeh King were jailed in Spain under a European arrest warrant issued by the Crown Prosecution Service for England and Wales after a Europe-wide search.1

After considering a treatment plan agreed by the Proton Therapy Centre in Prague, clinicians at Motol University Hospital in Prague, and the doctors who treated Ashya King at Southampton General Hospital, Mr Justice Baker agreed that the boy could be taken to Prague for the proton beam treatment the Kings want. The judge also ruled that the order making Ashya a ward of court, obtained by Portsmouth City Council, should be lifted once he reached Motol University Hospital, where he was taken on Monday 8 September.

Giving his reasons on the same day, the judge said that it was “a fundamental principle of family law in this jurisdiction that responsibility for making decisions about a child rests with his parents.” In most cases, he added, “the parents are the best people to make decisions about a child, and the state—whether it be the court, or any other public authority—has no business interfering with the exercise of parental responsibility unless the child is suffering or is likely to suffer significant harm as a result of the care given to the child not being what it would be reasonable to expect a parent to give.”

The judge said that medical staff were “understandably” very concerned that Ashya, who had a medulloblastoma removed on 24 July, would suffer significant harm when the Kings took him from the Southampton hospital on 28 August and that the local authority acted “entirely correctly” in applying to the High Court. Judge Gavyn Arthur was also right on the evidence before him to make Ashya a ward of court.

Mr Justice Baker said he would “make no comment” on whether it was appropriate to seek a European arrest warrant. But one consequence was that Ashya was separated from his parents and left alone for several days in a Spanish hospital, which was not in his best interests.

A week later the picture had changed, he said. The Kings had put together a treatment plan that was “coherent and reasonable” and made arrangements for funding and transport. Neither the local authority nor the Children and Family Court Advisory and Support Service, representing Ashya, opposed the plan, and University Hospital Southampton NHS Foundation Trust did not oppose it in principle. There was no reason to stand in the way of the parents’ proposal.

The judge said that some parents would have followed the advice of the treating doctors to choose conventional radiotherapy, while others would prefer the relatively untested option of proton beam therapy in the hope of reducing the toxic effects of radiation.

“Both courses are reasonable, and it is the parents who bear the heavy responsibility of making the decision. It is no business of this court, or any other public authority, to interfere with their decision,” he said.

The United Kingdom will not have proton beam therapy for brain cancers until 2018, although some patients are sent abroad for treatment. But NHS England will not fund proton beam therapy for medulloblastomas.

Clinicians at University Hospital Motol will decide on the amount and timing of the chemotherapy Ashya needs. The judge concluded, “We all send our best wishes to Ashya and his loving parents.”

Notes

Cite this as: BMJ 2014;349:g5570

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