The High Court of Justice ruled Thursday that the parents of Tafida Raqeeb may take her to Italy for medical treatment. The five-year-old girl has been comatose since February, and UK doctors want to remove her life-sustaining treatment.
Doctors at Royal London Hospital, where Raqeeb is on life support, had barred her parents (Muhhamed Raqeeb and Shalina Begum) from taking her abroad for treatment. Barts Health NHS Trust, which operates the hospital, had asked that the court find that ending Raqeeb’s life-sustaining treatment is in her best interest.
Alistair MacDonald, the High Court judge, wrote in his October 3 ruling that “where a child is not in pain and is not aware of his or her parlous situation, these cases can place the objective best interests test under some stress”.
“Tests must be looked for in subjective or highly value laden ethical, moral or religious factors… which mean different things to different people in a diverse, multicultural, multi-faith society,” stated MacDonald, who before his appointment as a judge practised family law, and is regarded as an expert on children’s rights.
He wrote that continued treatment was “consistent with the religious and cultural tenets by which Tafida was being raised”.
“There is no justification for interfering with the right to receive treatment in another EU member state,” the judge said.
“Transfer for treatment to Italy is the choice of her parents in the exercise of their parental responsibility and having regard to the sanctity of Tafida’s life being of the highest importance, I am satisfied, on a fine balance, that it is in Tafida’s best interests for life-sustaining treatment to continue,” Macdonald found.
The BBC reported that lawyers for Barts Health NHS Trust “said hospital bosses would consider appealing against the ruling.” They have 21 days to do so. The NHS trust said MacDonald’s decision “has clear ramifications that go beyond Tafida,” and could affect other patients being cared for in its hospitals. It stated: “The judge has granted us more time to consider the implications of this judgment for the Trust, other NHS organisations, doctors and patients.”
Two doctors from the Gaslini Children’s Hospital in Genoa examined Raqeeb via video link in July, and they agreed to care for her in Italy, saying they did not believe her to be brain dead. Her family have raised money for her transfer.
A lawyer for the Italian hospital told the court, according to The Evening Standard, that “When you drill down, it is based on differing views of what quality of life Tafida has. Clinicians (in England) don’t think she has a quality of life. Her parents do.”
Raqeeb suffered an arteriovenous malformation which resulted in a burst blood vessel in her brain, and has been in a coma since February 9.
The AVM triggered cardiac and respiratory arrest, as well as a traumatic brain injury. Doctors at the Royal London Hospital say there is no chance she will recover from her coma, and declared any further medical treatment futile.
Raqeeb’s family are Muslim, and have argued that Islamic law “said only God could take the decision to end her life,” the BBC reported.
Begum, a solicitor, has said she wants to “exercise her rights as a parent.”
Muhhamed Raqeeb said he and Begum were thrilled by the High Court’s judgement.
According to The Guardian, Begum said that “We have always had Tafida’s best interests at heart and we have never wanted to come to court to have to argue for our rights to seek continued care in a world-class hospital [the Gaslini] willing to give her the treatment she needs. The entire experience of having to fight for our daughter’s life over the last three months has been exhausting and traumatic for all of her family and we are glad it is now finally over.”
She added that Tafida “is not dying and we are continuously seeing small but important signs that she is gradually improving and we have always been hopeful that she might make something of a recovery if she is just given the time and the right treatment to continue to improve.”
Begum commented, “If it happens to me, I want my life to continue until a time that God actually takes me, not withdraw life support from me.”
David Lock, a barrister for Raqeeb and Begum, said the judgement was an “enormous relief” and that the family “wanted to get on with the transfer” to Gaslini Children’s Hospital.
And Paul Conrathe, a solicitor for the family, said MacDonald’s ruling recognized “that a child’s best interests are not merely medical, but include broader social and religious values. It also recognised the legal right of parents to request life-prolonging treatment in another EU state so that their child can be treated under that system of care and ethics.”
He added, according to The Telegraph, that Raqeeb’s parents “look forward to her receiving outstanding care at the Gaslini hospital in Genoa. They will also feel at peace knowing that Tafida will be cared for under the Italian ethical and legal system.”
Bishop John Sherrington, an auxiliary bishop of Westminster and the English and Welsh bishops’ representative on life issues, welcomed the ruling, which he said “has taken account of the wishes of Tafida’s parents and their innate urge to do all they can to help their daughter in what are truly tragic circumstances. The heart-breaking illness of Tafida Raqeeb and the distress which the illness of a child causes parents touches the hearts of many people.”
“I trust that all the medical professionals will cooperate to continue to give her the best possible care and appropriate treatment. Such international cooperation is essential good practice in the care of tragically difficult lives,” he continued.
In July, Bishop Sherrington had urged that the public be reserved in judgement on Raqeeb’s case, saying that “difficult dilemmas have to be faced. In that process, I hope that all due weight will be given to the wishes of her parents, while also respecting the clinical judgement of the doctors caring for her. Those of us not in possession of all the relevant information might best be reserved in our judgement.”
Katie Gollop, a barrister representing Barts Health NHS Trust, said MacDonald’s ruling could affect other children.
Raqeeb’s case follows similar campaigns by parents with children in NHS care. Charlie Gard, Alfie Evans, and Isaiah Haastrup were all gravely ill children on life-support treatment. The parents of each of those children lost court battles in recent years against hospitals that wanted to end their treatment, and prohibit them from being taken abroad for treatment.
The NHS trust cited both Gard’s and Evans’ cases in its arguments against continuing treatment for Raqeeb and against allowing her to receive treatment elsewhere.