The Vexed Question of Best Interests in Decisions Relating to Infants and Medical Futility

Seemingly intractable disagreements between parents and doctors about the treatment of gravely ill infants are neither new, nor particularly unusual. In the clinical context, proposed courses of treatment are usually discussed and agreed between the clinical team and those with parental responsibility. For critically ill infants, where withdrawal of treatment is being considered, a multidisciplinary team meeting is usually held to decide on the most appropriate course of action in light of the child’s condition and prognosis. Multiple meetings may be necessary particularly where the child’s condition is unstable, or where the diagnosis or prognosis is in doubt. While the aim of these meetings is partly about reaching a consensus, this cannot always be achieved and recent high profile cases demonstrate very graphically the far reaching and damaging effects of fundamental disputes about withdrawal of treatment decisions based on medical futility.