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Posted on February 9, 2020 at 4:00 AM

In early October 2019, clinicians at Manchester University Hospital determined that Midrar Namiq was dead. But, more than four months later, he is still in the hospital.


At the end of January 2020, the High Court ruled that clinicians could stop treatment. But the parents appealed. The UK Court of Appeal is still considering the case.


Interestingly, the relevant guidance from the Royal College of Paediatrics and Child Health (RCPCH) identifies brain death as an example of a circumstances “where it may be appropriate to consider limitation of treatment.” But this permissive language erroneously suggests that it might be in a child’s best interest to receive treatment after being determined dead.


The Royal College identifies three situations in which it is appropriate to limit treatment: (1) limited quantity of life, (2) limited quality of life, and (3) informed supported refusal of treatment. The Royal College includes brain death as one type of “limited quantity” along with imminent death and inevitable demise. But this placement seems to confuse things. After death, there is no life. So, it makes no sense to discuss the quantity or quality of that life.


Fortunately, the Royal College clarifies that “When death is diagnosed following formal confirmation of brain stem death by agreed medical criteria, intensive technological support is no longer appropriate and should be withdrawn.”


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