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  • Title: Re J (A Minor) (Wardship: Medical Treatment).
    Author: Great Britain. England. Court of Appeal, Civil Division.
    Journal: All Engl Law Rep; 1992 Jun 10; [1992] 4():614-26. PubMed ID: 11648313.
    Abstract:
    The Civil Division of England's Court of Appeal overturned the lower court's order of mechanical ventilation for a profoundly handicapped sixteen-month-old child against the clinical judgment of the child's doctors. Since hitting his head in a fall at age four weeks, J had not mentally developed past that time and he was blind and he suffered from severe cerebral palsy and epilepsy. He required nasogastric tubal feeding and, although he occasionally responded to sound, whether or not he recognized his caregivers was uncertain. His divorced mother and the local authority shared parental authority over J, who resided with foster parents. The consultant pediatrician reported that if J were to suffer a life-threatening event, ordinary resuscitation, antibiotics and physiotherapy would be appropriate, but intervention with intensive measures including mechanical ventilation would be medically inappropriate. Two other specialists agreed with those findings, but another consultant found mechanical ventilation not to be cruel and thought J could be weaned from it if it became so. The mother and local health authority asked the court to require the health authority to continue all treatment, including mechanical ventilation, of J. The Official Solicitor and the health authority opposed such an order. The lower court granted an interim order requiring mechanical ventilation if necessary over the five weeks prior to the main hearing. The appellate court viewed such an order as an abuse of judicial power and held that the physician's duty to the patient is to treat with the necessary consent in accord with the best clinical judgment and that, as long as those with parental authority consent to J's treatment by the health authority, he must be treated in accord with the best clinical judgment of that authority's personnel.
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