FD24P00611 - [2025] EWHC 1042 (Fam)

I will take this shortly as it is not in issue between the parties.

MG is now 3 years and 4 months old. He is a much loved child of his parents and a much loved member of his entire family. He has an elder and a younger sister. I have seen a video of him which was taken while he was in intensive care. From that I can see that he is a handsome child, who even when in a hospital bed, is well presented.

MG was diagnosed with B cell precursor acute lymphoblastic leukaemia on 19 April 2024 and started receiving chemotherapy. His parents were told that this treatment had a 90% success rate. On the 24 May 2024, after 5 weeks of induction chemotherapy, he had a sudden neurological collapse (the stroke). Scans of his brain showed that he had a large clot in one of the main blood vessels supplying blood to the brain.

On the 3 June 2024 his pupils stopped reacting and an MRI scan showed a haemorrhage with hydrocephalus. He had an operation and an EVD was inserted to relieve the pressure on his brain. The EVD has remained in place. Since this episode MG has remained ventilator dependant and in an intensive care unit at Great Ormond Street Hospital. He has had to have chest physiotherapy and suctioning of secretions. He is fed through a nasogastric tube.

The medical opinion is that MG has suffered a catastrophic brain injury from which he cannot recover. His brain stem is irrecoverably damaged, I am told. The medical opinion is that since this incident occurred MG does not react purposefully to his environment. He does have some reflex movements and he does have other movements, but they are not, according to the medical opinion, any sign of consciousness. The parents consider that some of MG’s movements do relate to his environment. As I have already said, I have been shown a video of him with his mother and his younger sister when it is clear that he does move. The medical opinion is unequivocal that such movement is not in response to the environment; it is just occasional movement.

It is not necessary for me to chart the progress of the differences between the parents and the Trust in relation to the care which MG should receive. I mention only that the Trust held an Ethics Case Review in July 2024 in which it was concluded that it would be in MG’s best interest for life sustaining treatment to stop. Second opinions were obtained in August 2024. In October 2024 mediation was attempted with the parents.

I will repeat that the case is remarkable as to the respect which each party affords the other. Nonetheless the differences between the Trust and the parents were not resolved and proceedings were issued in December 2024 and statements were prepared on behalf of the Trust. Mrs Justice Judd gave directions in that month, and made a declaration that MG lacked competence to consent to or refuse medical treatment. That is not controversial.

On the 13 January 2025, following statements from the parents, a further MRI scan and EEG were carried out. I was told they showed no meaningful improvement in MG’s health. That was followed on the 31 January 2025 by second statements from Dr B and Dr A.

The matter was transferred to me by Judd J and I gave directions (by consent) that the parents could instruct Professor Playfor. A provisional earlier hearing of this matter then had to be adjourned because of the ill health of a witness.