Charlotte Wyatt -- Don't give up on me!





bullet Doctors told to let baby Charlotte die

Father pleads with judge for his child's right to live


Parents fight medics over right to let baby die

NOTE from CHN  For similar cases where Doctors deem disabled infants as having no hope, see:

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Note this quote: "It is unusual for doctors and parents not to agree about whether or not to resuscitate a very seriously ill baby but when no consensus can be reached the only way forward is for the case to go to court," Michael Wilks, chairman of the BMA's ethics committee, said."   Apparently in this context of "futility", "consensus" now means agreeing with the doctors.  Nancy Valko, RN


Thursday October 7, 0714 PM

bullet Doctors told to let baby Charlotte die

By Jeremy Lovell

LONDON (Reuters) - The parents of a premature baby have lost their battle to force doctors to keep tiny 11-month-old Charlotte alive if she stops breathing a fourth time.

The case, pitting the rights of Darren and Debbie Wyatt to fight for the life of their dying, deaf baby against the power of doctors, has touched a national chord

Doctors say Charlotte has a terrible quality of life, with "no feelings other than continuing pain", and asked the judge to approve a High Court decision last month not to resuscitate her if she stopped breathing again.

The Wyatts argued she had a real chance of survival and said doctors should do all they could to keep her alive.

"I have come to a clear view I do not believe any further aggressive treatment to prolong her life is in her best interests," Justice Hedley told London's High Court.

"The medical advice is that she should be allowed to die peacefully in her parents' arms if that is the natural course, and she should be supplied with all palliative care," he added.

Charlotte was born by caesarean section at 26 weeks, with a birth weight of 458 grams (16 oz) and nearly a year later weighs just 5.6 kg (12.4 lb).

She needed ventilation for most of the first three months. Her breathing has stopped three times as a result of heart and lung conditions and she is fed through a tube.

Specialists say she cannot survive beyond infancy and may never be able to leave hospital.

"Can she respond to human contact or human love? Is there any real prospect that her sensory faculties might develop further?" the judge asked.

Richard Stein, a lawyer for Charlotte's parents, said outside the court they would not appeal against the ruling.

"They have asked me to say that they feel it was most important that the issues in this case have been aired in public because as a result everyone has an opportunity to consider the extremely difficult issues faced by them and numerous other families."

A spokeswoman for the hospital where Charlotte is being treated said doctors would give her the best medical care until the end.

The British Medical Association, which represents doctors, said the case had been fraught, but the judge made the right decision.

"It is unusual for doctors and parents not to agree about whether or not to resuscitate a very seriously ill baby but when no consensus can be reached the only way forward is for the case to go to court," Michael Wilks, chairman of the BMA's ethics committee, said.

"The BMA is confident that Mr Justice Hedley ... has made the right decision in the best interests of Charlotte Wyatt."





Father pleads with judge for his child's right to live

KAREN MCVEIGH   October 2, 2004

THE father of the seriously-ill baby Charlotte Wyatt made a heartfelt plea to a High Court judge yesterday not to give doctors the right to let her die.

Darren Wyatt, 33, said his 11-month-old daughter was "a fighter" who was not ready to let go. He rejected the medical teamís case that to resuscitate her if her condition worsened would be "futile and cruel". He believed in miracles, he said.

"When you get to the stage that you grow to love someone, you canít just throw her away like a bad egg," he told Mr Justice Hedley. "Iíve been there, Iíve held her hand and sheís gripping on to my finger and you can see the response. She knows who we are and that we are her parents. I donít think she wants to give up at all."

Mr Wyatt, speaking on behalf of himself and his wife, Debbie, 23, challenged the case put forward by Portsmouth Hospital NHS Trust that their baby, who has spent every day of her short life in hospital, lived a life of "intolerable pain".

Charlotte, who was born three months premature, has severe cerebral palsy and chronic lung disease which was described by one paediatrician as the worst case they had come across. She cannot see or hear, is fed through a tube because she cannot suckle and requires a constant supply of oxygen.

Her team of consultants have said they believe she suffers "intolerable pain" and that her quality of life is "both terrible and permanent".

Mr Wyatt, of Buckland, Portsmouth, told the judge that the occasions when he and his wife had been able to hold Charlotte and cuddle her and bathe her were very special moments.

He said: "Over the past 11 months, weíve been bonding and you grow to love a child. In our eyes, we believe that Charlotte should have everything - everything should be done to keep her alive."

He conceded that, if the time came when the baby was really suffering, he would have to change his mind. "But I believe there are things in medical science to help her carry on, even for a couple of years, and she can even go outside and see the trees and whatever," he said.

He said that, last week, he and his wife had cuddled their daughter and she seemed to settle as a result. "We had her out for up to half an hour and Charlotte felt so comforted. We could see it. It really, really comforted her. I held her for about 15 minutes and Debbie had her for ten, and she even fell asleep. I could tell how much it comforted her - her oxygen level needs went down."

A devout Christian, Mr Wyatt said: "I do believe in miracles. If the man upstairs says this person should live, then that person will live."

Mrs Wyatt, who is three months pregnant with their third child, broke down in tears as she watched her husband give evidence. At one point, she was comforted by one of the medical team.

The couple have accepted that the care their daughter has received has been of the highest standard.

Mr Wyatt said doctors should now perform a tracheostomy - the insertion of a breathing tube through the throat - so long as Charlotte did not suffer. That would allow her to come out of her oxygen box and have a lot more cuddles, he said.

If, after five days or so, she continued to deteriorate and reached a "no-no" situation, she could be handed back to "TLC". He said: "Then, we would just be there, comforting her and holding her for her last moments and we would let her go and then, thatís it. But, at the moment, she is not at that stage."

The judge said he appreciated the urgency of the case, but he would not be able to give a considered decision until next Thursday.



Parents fight medics over right to let baby die

KAREN MCVEIGH  Octobet 1, 2004

THE parents of a desperately ill baby girl yesterday challenged at a High Court hearing the view by doctors caring for her that, should her condition worsen, she should be left to die.

Debbie Wyatt, 23, who is pregnant with her third child, and her husband, Darren, 33, listened as a succession of medical experts gave evidence about the "intolerable pain" caused by their premature daughter's chronic lung disease - described as the worst that one paediatrician had ever seen - and severe neurological problems.

The team of consultants caring for 11-month-old Charlotte Wyatt, who cannot see or hear, believe that she has "no feelings other than continuing pain" and a quality of life that is "both terrible and permanent". They say she will not survive beyond infancy and, even if she did, would not leave hospital. It would be "futile and cruel" to resuscitate her if she stopped breathing for a fourth time, Mr Justice Hedley was told.

Charlotte's parents oppose the application by Portsmouth Hospital NHS Trust for an order allowing doctors not to resuscitate her.

A consultant paediatrician, known as Dr E, who took over caring for Charlotte in August, said that, even if she were to be resuscitated after developing breathing problems, she would have a chance of survival of between "one per cent" and "approaching zero".

Mrs and Mrs Wyatt, who have given up work because of the stress caused by caring for their daughter, say she has battled hard against the odds thus far and that doctors should do everything to keep her alive.

At one point, Mrs Wyatt slumped in her seat and placed her head in her hands as she heard doctors give their negative prognosis.

Charlotte, born three months premature at St Mary's Hospital in Portsmouth, and so small at birth that she fitted into the palm of her mother's hand, has spent every day of her short life in hospital. Her last infection caused further damage to her brain, which has virtually stopped growing, and lungs. She now relies on oxygen delivered to her in a box that encases her tiny head. It is such a high concentration of oxygen - between 80 and 90 per cent compared with the normal level in air of 20 per cent - that the oxygen itself can damage her lungs. She never smiles, will never be able to eat properly, is fed through a tube and often becomes distressed when handled.

Dr E told the hearing that Charlotte, who now weighs 12lbs and measures 21 inches, is mostly in a distressed state.

David Wolfe, on behalf of her parents, said Charlotte had recently been taken out of her oxygen head-box and cuddled by Mr and Mrs Wyatt and had "settled" in response. Another Doctor, Dr G, had stroked her while she lay in the box and she settled, he said. Dr E responded that Dr G had seen her "on a very good day" for a couple of hours at the most.

Mr Wolfe asked Dr E whether Charlotte's life was "not intolerable" on good days, as opposed to bad days. Dr E said that was "a judgment call" and went on: "[Lying] in a hospital box, surrounded by beeping machines, not being able to interact with her environment, with no prospect of change, strikes me as being fairly intolerable. I think that is why we are here."

Although Charlotte's brain damage made it difficult to assess whether she felt pain, her reactions showed her to be often "visibly distressed, with anguish on her face and writhing about", Dr E added.

Earlier, Dr E said Charlotte had received life-saving ventilation five times and had suffered lung scarring. This had created a "vicious circle", making it difficult for her to breathe.

The baby was on a "knife-edge", susceptible to the many respiratory infections around, the doctor said. If she became infected, particularly by a virus, she was "likely to deteriorate dramatically" and she could require re-ventilation.

Dr E added that, at first, Mr and Mrs Wyatt had appeared to agree with that opinion "but more recently it has become very apparent they don't agree, and it is a situation, therefore, that we cannot move forward in". The doctor said that, as Charlotte's condition might well deteriorate further in the next few weeks, "we felt it important to come to the court to let somebody else make the decision for us".

Mr and Mrs Wyatt, both committed Christians, of Buckland, Portsmouth, have visited Charlotte in hospital every day, sometimes with their son, Daniel, aged 20 months. Mr Wyatt has three children, aged 13, 12 and eight, from a previous marriage.

They are convinced that, on a good day, their daughter recognises them, and they believe that she can even smile.

A neurologist, Dr C, told the hearing that Charlotte's level of brain growth was so low that it indicated permanent brain injury. Dr C told the court that the baby had no response to visual and auditory stimuli, could not control her body and did not smile.

Mr Wolfe asked Dr C if, at any point, Charlotte could ever experience pleasure, for instance, if she developed enough to be fed by mouth, or if she was able to feel the air on her skin.

Dr C said that it was likely that choking and distress would negate any pleasure from eating but replied "yes that would help" if she felt air on her skin.

When asked by Mr Wolfe if her life, post-ventilation, would be "universally intolerable" Dr C replied that "any physiological pleasure would be outweighed" by her problems.

Dr C added that Charlotte would have a "very, very high level of dependence on technology - that, I think, would be intolerable".


THE High Court battle over baby Charlotte Wyatt revisits a moral debate that has been raging for many years.

The arguments echo those made almost a decade ago in the case of Jaymee Bowen, referred to in court as child B, whose father, David, fought unsuccessfully to force Cambridge Health Authority to continue treating her.

In 1995, Jaymee, then aged ten, was given eight weeks to live by doctors after the health authority refused to pay the '75,000 for specialist blood transfusion treatment, saying her chances of survival were slim. Having lost the legal fight, which went to the Court of Appeal, an anonymous donor paid for Jaymee to be treated at the private Portland Hospital in London. She died on 22 May, 1996, aged 11.

The case divided the medical profession. Dr Peter Gravett, who treated Jaymee at the Portland Hospital, said at the time: "I would still do the same thing to the same person in the same circumstances. As for the cost of the treatment, is it worth '6,000 a month to have an 11-year-old girl running around' Jaymee's treatment seems like value for money."

But Nigel Pitt, representing Cambridge Health Authority, said: "If health authorities spent their money on treatments which doctors thought extremely unlikely to succeed and then had no money left to treat hundreds of other patients who might have been effectively treated, what would the public say about that'"

The argument over whether treatment should be continued in cases where there was a slim chance of survival or of a "meaningful" life was played out in the cases of two victims of the Hillsborough football stadium disaster in 1989.

Both Tony Bland and Andrew Devine were seriously injured and diagnosed as being in a Persistent Vegetative State (PVS), from which they were not expected to recover. Mr Bland's parents approved, for the first time in British legal history, the decision of doctors to allow their son to be allowed to die by the withdrawal of food and treatment. But treatment was continued for Mr Devine who, eight years after the accident, awoke from the coma to the extent he could communicate with a buzzer.

There are General Medical Council guidelines on when treatment should be discontinued such as in cases when patients can no longer communicate. They were thrown into disarray in July when terminally-ill Leslie Burke won a court action to force doctors to continue treating him. The ruling is open to appeal.




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