The spectre of so-called “assisted dying” is rearing its head again, as the British Medical Association controversially changes its stance to “neutral” and Baroness Meacher’s private member’s bill is soon to have its second reading. The sad case of Alta Fixsler, a brain-damaged Hasidic Jewish girl, reveals not only that euthanasia without consent is already happening, but sheds light on the contempt for religious belief in these cases.
Alta was born eight weeks premature. During her birth, she suffered severe brain injury through lack of oxygenated blood. Thanks to the wonders of modern medicine, Manchester NHS Trust managed to keep her alive. She is now two-and-a-half. The prognosis is not great – no realistic chance of recovery and a life expectancy measured in months. Now the NHS Trust wants to end her life.
The NHS is seeking to withdraw her life-sustaining treatment because in their view she experiences “consistent pain”. This is disputed, not least by Dr Rajesh Munglani, a leading medical authority in the field of pain and a consultant in pain medicine at the Royal Papworth Hospital. Nor does this claim ring true to her loving parents; mothers especially have a sense of these things. Until this year no consultant or medical staff at the hospital had ever raised the issue of pain.
Alta’s parents, Abraham and Chaya Fixsler, do not consent to treatment being withdrawn – both on religious grounds and also because they see no reason to end the life of an unconscious but content little girl they have brought into the world.
Consequently, they have been taken to the High Court by the NHS. It is a particularly cruel feature of the English legal system that Alta, as represented by an NHS-appointed guardian, is pitted against her own parents in court.
At the heart of the legal battle lies two related tests in which those without mental capacity have decisions made on their behalf by the court. The first is “best interest” in which the court attempts to reconcile a range of complex factors into what is “best” for two-year-old Alta Fixsler. The second is “substituted judgment” in which the Judge attempts to imagine him or herself in the place of, in this case, an unconscious, brain-damaged toddler born into Hasidic Judaism, to determine what she would decide.
In his ruling, using the persuasive doublespeak that the judiciary specialise in, Justice MacDonald pronounced:
“I have no hesitation in accepting the submission that an assessment of the various dimensions of Alta’s best interests must take into account the particular religious, cultural and ethical context of this case … However, within the well-established legal framework summarised above, such matters remain at all times simply factors to be placed into the overall best interests evaluation.”
He then comprehensively, and by his own admission, ignores Alta’s religion in his judgment:
“In the circumstances, and having examined Alta’s best interests from a broad perspective, encompassing medical, emotional, sensory and instinctive considerations, and having paid due regard to the fundamental, but not immutable principle of the sanctity of life, as well as the parents’ deeply held religious convictions, it is with deep regret that I am satisfied that it is not in Alta’s best interests for life-sustaining medical treatment to be continued and in her best interests for that treatment now to be withdrawn and to be moved to a palliative care regime.”
For her parents, and the family’s rabbi, Israel Goldberg, the issue is unequivocal.
“In our faith, it is strictly forbidden to actively shorten a life. The only circumstances under which this might be permissible is where someone is in constant suffering and pain, but we do not believe that these circumstances apply to Alta.”
Alta’s parents want to allow her to live the rest of her short life as best she can, together, as a family.
“God gave her to us,” says her father, “who are we to take that life away?”
Having won the legal right to withdraw treatment, the NHS Trust have now gone further and -– in an incomprehensible act of bad faith – have determined that they will not allow Alta to die at home, in accordance with Jewish custom.
What if Alta were Roman Catholic? Catholics and traditional Jews are broadly aligned as regards this aspect of end-of-life. The 1980 Declaration on Euthanasia, the Catholic Church’s official document on the topic, declares euthanasia as a “crime against life” and a “crime against God”. The Declaration goes on to remind us that love and human care are at the heart of the matter: “What a sick person needs, besides medical care, is love, the human and supernatural warmth with which the sick person can and ought to be surrounded by all those close to him or her, parents and children, doctors and nurses.”
In 2017 Pope Francis, addressing the World Medical Association meeting in the Vatican, reinforced this, acknowledging the “growing therapeutic capabilities of medical science”, warning against “overzealous treatment”, but stressing that the imperative is never to abandon the sick: “The anguish associated with conditions that bring us to the threshold of human mortality, and the difficulty of the decision we have to make, may tempt us to step back from the patient. Yet this is where, more than anything else, we are called to show love and closeness, recognising the limit that we all share and showing our solidarity. Let each of us give love in his or her own way – as a father, a mother, a son, a daughter, a brother or sister, a doctor or a nurse. But give it!”
Sadly in Alta’s case, she will die a long way from the loving embrace of her family home. Her ventilation will be withdrawn, as will her feeding tubes in an institution unfamiliar to the family and tainted by the battle that has raged for nearly a year. She may cope with the act of breathing by herself, she may not. The doctors do not know. But she will certainly starve to death through loss of nutrition.
To some this tragic story represents little more than a moral dilemma in which the heartbroken family are subordinated to experts within the mighty NHS, backed up by the power of the courts. But this is child euthanasia without consent and goes against the very precepts not just of the family’s Jewish faith, but other faiths as well.
Justin Doherty is a campaigner on end of life issues.
This article first appeared in the October 2021 issue of the Catholic Herald. Subscribe today.
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