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Health Care Analysis
Published in:

Open Access 18-12-2023 | Triage | Original Article

The Effects of Introducing a Harm Threshold for Medical Treatment Decisions for Children in the Courts of England & Wales: An (Inter)National Case Law Analysis

Author: Veronica M. E. Neefjes

Published in: Health Care Analysis | Issue 3/2024

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Abstract

The case of Charlie Gard sparked an ongoing public and academic debate whether in court decisions about medical treatment for children in England & Wales the best interests test should be replaced by a harm threshold. However, the literature has scantly considered (1) what the impact of such a replacement would be on future litigation and (2) how a harm threshold should be introduced: for triage or as standard for decision-making. This article directly addresses these gaps, by first analysing reported cases in England & Wales about medical treatment in the context of a S31 order, thus using a harm threshold for triage and second comparing court decisions about medical treatment for children in England & Wales based on the best interest test with Dutch and German case law using a harm threshold. The investigation found that whilst no substantial increase of parental discretion can be expected an introduction of a harm threshold for triage would change litigation. In particular, cases in which harm is limited, currently only heard when there are concerns about parental decision-making, may be denied a court hearing as might cases in which the child has lost their capacity to suffer. Applying a harm threshold for triage in decisions about withholding or withdrawing life-sustaining treatment might lead to a continuation of medical treatment that could be considered futile.
Appendix
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Footnotes
1
The Federal Constitutional Court is the highest constitutional court in Germany.
 
2
A condition previously known as Persistent Vegetative State. The current medical term is Prolonged Disorder of Consiousness.
 
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Metadata
Title
The Effects of Introducing a Harm Threshold for Medical Treatment Decisions for Children in the Courts of England & Wales: An (Inter)National Case Law Analysis
Author
Veronica M. E. Neefjes
Publication date
18-12-2023
Publisher
Springer US
Keyword
Triage
Published in
Health Care Analysis / Issue 3/2024
Print ISSN: 1065-3058
Electronic ISSN: 1573-3394
DOI
https://doi.org/10.1007/s10728-023-00472-w

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