The Archie Battersbee case

[Cack Conroe]

Okay so if he’s not dead remove the ventilator, remove the machines and the medication and let him show us he isn’t dead. Doctors and nurses are people who have patients interests as their best intentions, keeping a boys heart beating for the sake of his mother is not his best intention.

I am fully aware that Archie will die without a ventilator, that his body will continue to deteriorate, and I personally agree that all treatment should be removed.

However, you could use that definition of “dead” to apply to anyone who will die without medication or treatment.

Archie is only a corpse in a figurative sense.

Brain stem death is legal death because it’s necessary both for organ donations, and for futile situations like these. It’s not physical death except of the brain or brain stem itself.

I just don’t think it’s helpful to be calling him a corpse. It seems vitriolic and is confusing to those who haven’t looked into the situation, and it won’t at all help Hollie and the “don’t slaughter Archie” side to understand.

 

[ButterTart]

From the NHS (emphasis is theirs):

Brain death (also known as brain stem death) is when a person on an artificial life support machine no longer has any brain functions. This means they will not regain consciousness or be able to breathe without support.

A person who's brain dead is legally confirmed as dead. They have no chance of recovery because their body is unable to survive without artificial life support.

This makes literally no sense:
Archie is only a corpse in a figurative sense.

Brain stem death is legal death because it’s necessary both for organ donations, and for futile situations like these. It’s not physical death except of the brain or brain stem itself.

A corpse is a corpse. Imaging has shown the deterioration of his brain stem and brain. Ergo, legally confirmed as dead. He cannot regulate any of his own bodily functions and if removed from a ventilator his heart would cease beating. Ergo ... dead/a corpse, with or without the ventilator. So brain death absolutely equates to physical death.

 

[Rekyavikgirl]

I am fully aware that Archie will die without a ventilator, that his body will continue to deteriorate, and I personally agree that all treatment should be removed.

However, you could use that definition of “dead” to apply to anyone who will die without medication or treatment.

Archie is only a corpse in a figurative sense.

Brain stem death is legal death because it’s necessary both for organ donations, and for futile situations like these. It’s not physical death except of the brain or brain stem itself.

I just don’t think it’s helpful to be calling him a corpse. It seems vitriolic and is confusing to those who haven’t looked into the situation, and it won’t at all help Hollie and the “don’t slaughter Archie” side to understand.

'corpse' isn't used in a vitriolic sense at all by me or a lot of others. Quite a few posts have emphasised the respect shown to people after they have died by medical staff (and especially nurses) and that would include Archie. I would argue that the medical staff respect Archie far more than his own mother does.

 

[Cack Conroe]

Isnt death usually decided by the medical staff caring for a patient? Its a doctor that usually signs a death certificate, then the courts will ratify that decision.

Yes, but in this case no doctors have declared Archie dead. His brain is dead as shown in MRI scans and EEGs, but in the only way of legally declaring someone brainstem dead is to follow certain tests, which could not be performed on Archie. Normally the family would agree to remove life support, the patient would then die and would be declared dead afterwards in the usual way.

It is a technical point yes......technically Archies body is still alive. But it sounds from all the ITU staff on here, as if once the brain dies, then normal bodily functions also die..so he cant function at all by himself. He is breathing artificially but he also is unable to absorb any kinds of food or drink into his cells independently, so everything within him is deterioriating. I spose technically he is some kind of living corpse? And they couldnt do the usual test for brain stem death, due to the damage at his neck, so what are they meant to do

Medical staff arent superhuman, they are trying their best to help. Its ok to ask for a second opinion, especially with a case like this, but....if the second opinon confirms the diagnosis of the first...

That’s the thing, there is only one legal way to declare a person brainstem dead and that is by testing brainstem reflexes, which couldn’t be done.

There is no legal precedent for declaring someone brainstem dead by MRI scan evidence.

The hospital were not going to try to get him declared dead, and instead wanted to be allowed to withdraw treatment on the basis that it’s in his best interests, then declare him dead afterwards in the usual way. But Archie’s legal guardian (a social worker, not a medical or legal professional) encouraged them to try to get him declared dead. So they did, and the judge agreed, but they shouldn’t have done it. It gave the parent’s their entire legal means to appeal. If the hospital had gone down the best interests route in the first place, the appeal may not have happened and Archie would have been let go already.

I am sorry for the loss of your dad, it must have been devastating.

Thank you

 

[Rekyavikgirl]

I am sorry about your dad too @Cack Conroe. I'm not going to comment anymore.

 

[Cack Conroe]

From the NHS (emphasis is theirs):

Brain death (also known as brain stem death) is when a person on an artificial life support machine no longer has any brain functions. This means they will not regain consciousness or be able to breathe without support.

A person who's brain dead is legally confirmed as dead. They have no chance of recovery because their body is unable to survive without artificial life support.

This makes literally no sense:
Archie is only a corpse in a figurative sense.

Brain stem death is legal death because it’s necessary both for organ donations, and for futile situations like these. It’s not physical death except of the brain or brain stem itself.

A corpse is a corpse. Imaging has shown the deterioration of his brain stem and brain. Ergo, legally confirmed as dead. He cannot regulate any of his own bodily functions and if removed from a ventilator his heart would cease beating. Ergo ... dead/a corpse, with or without the ventilator. So brain death absolutely equates to physical death.

This is like banging my head against a brick wall.

 

[Merpedy]

They will rule on best interests.

And they are only ruling on best interest because it's an available avenue. If it wasn't we'd likely be extending the criteria to be declared brain stem dead to fit those of Archie as the test can't be carried out because it would be unreliable - it's essentially acting on a benefit of doubt angle where there's the smallest unlikely chance that he could be alive and the test wouldn't catch it as I'd understand anyway

Cruel? No, he is not capable of suffering.

I find this a bit weird? I understand he can't feel pain but from what I have gathered the treatments he is receiving are actually harsh on the physical body and that's been part of the discussion in court by the sound of it

A corpse is a corpse. Imaging has shown the deterioration of his brain stem and brain. Ergo, legally confirmed as dead. He cannot regulate any of his own bodily functions and if removed from a ventilator his heart would cease beating. Ergo ... dead/a corpse, with or without the ventilator. So brain death absolutely equates to physical death.

The one thing I have taken away from all of this is that it's absolutely amazing that we're able to keep someone 'alive' even after they have basically passed away

 

[HoGi]

Isn't the only reason they haven't done the brain stem test because the pre-test muscle tests failed. So they couldn't say the brain stem tests would be accurate.

Whilst I appreciate in a legal sense, without a brain stem test he is "alive" it's just words. He is dead in every sense except the legal one at this point in time.

 

[Tui]

I’m sorry, but you do talk such a lot of utter bollocks.

I know right? This isn’t about personal ethical beliefs. This is about the medical fact that you need a brain to survive

Isn't the only reason they haven't done the brain stem test because the pre-test muscle tests failed. So they couldn't say the brain stem tests would be accurate.

Whilst I appreciate in a legal sense, without a brain stem test he is "alive" it's just words. He is dead in every sense except the legal one at this point in time.

Exactly. My understanding is that test to to ensure the muscle relaxants have worn off so they don’t prejudice the results. In Archie’s case his spine is rotting so he has no peripheral nervous responses

Yes, but in this case no doctors have declared Archie dead. His brain is dead as shown in MRI scans and EEGs, but in the only way of legally declaring someone brainstem dead is to follow certain tests, which could not be performed on Archie. Normally the family would agree to remove life support, the patient would then die and would be declared dead afterwards in the usual way.



That’s the thing, there is only one legal way to declare a person brainstem dead and that is by testing brainstem reflexes, which couldn’t be done.

There is no legal precedent for declaring someone brainstem dead by MRI scan evidence.

The hospital were not going to try to get him declared dead, and instead wanted to be allowed to withdraw treatment on the basis that it’s in his best interests, then declare him dead afterwards in the usual way. But Archie’s legal guardian (a social worker, not a medical or legal professional) encouraged them to try to get him declared dead. So they did, and the judge agreed, but they shouldn’t have done it. It gave the parent’s their entire legal means to appeal. If the hospital had gone down the best interests route in the first place, the appeal may not have happened and Archie would have been let go already.




Thank you

Legally it’s all very interesting and precedent setting. But ultimately ongoing treatment is futile.

 

[Merpedy]

It is so dangerous that this should be considered in court: that the personal ethical beliefs of staff should be a factor in whether to treat someone

And if the courts were to say "you have to treat him" the staff would because the staff themselves aren't in a position to just throw down their duties and responsibilities just like that. Realistically, I can't ever see a case where someone is allowed by the courts to die or go untreated because doctors or nurses don't feel comfortable doing that work

 

[Tui]

Dignity is a matter of opinion, it is not legally defined.

Except when the family are acting against the best interests of a child, and then matters of dignity are very much defined by the judge. You are talking esoteric bollocks

 

[teabob]

Is the fact that he’s dead in debate? This is from the judgment on the 13th of June that was posted on this thread.

 

[unimpeded]

His brain is dead.

Are you saying his brain is dead but doesn't have brain death?

 

[Rekyavikgirl]

I know we aren't supposed to tone police but I think people's convictions often stem from their own painful experiences. We can disagree without using insults. There's a lot of sadness on this thread.

 

[GalaxyGirl70]

I think the staff looking after this boy (and extremely well given he's been technically dead for 3 months) must be so anxious of a cardiac episode over the coming days.

I've had an awful day, have got a touch of heat exhaustion but I wouldn't want to be on duty looking after Archie for any amount of pay right now.

 

[nini01]

No, what I wrote is legal fact. NOT my opinion.

He is not dead until the courts say so, which they haven’t as the last is being appealed. The judge strongly advised against ruling anyone dead in that unprecedented manner again.

He was unable to be declared brainstem dead because the tests could not be completed.

Therefore, he is not legally dead.

His body is still alive. It is not a corpse. All kinds of processes would have to be being followed if his body was considered a corpse.

31st may 2022 12pm the courts has said that was the date he died. It’s in the court transcripts and recorded on medical notes. Just because the family appealed this doesn’t reverse the fact they already have put his time and date of death down. If Friday they state otherwise then he isn’t classed as dead.

 

[super grateful]

I still don’t quite get why they can’t do the brain stem testing now if that’s all they need to confirm things for the family’s reassurance. Any muscle relaxing medications he was given very early on would be well worn off by now and he 100% meets the criteria for testing. I’m not sure how he didn’t meet the criteria to begin with tbh, as it’s never properly been released in detail.

But given he was declared dead on 31st May, and will have a death certificate stating that day (as required), I imagine anymore tests won’t be happening.

Another reason for ethical and emotional distress, by the way. Looking after a patient with a filled out death certificate isn’t normal.

 

[iieee]

Is the fact that he’s dead in debate? This is from the judgment on the 13th of June that was posted on this thread.
View attachment 1411697

That was the ruling from the first court case. They were granted the right to appeal it and the appeal is taking place currently.

 

[Weeder]

I still don’t quite get why they can’t do the brain stem testing now if that’s all they need to confirm things for the family’s reassurance. Any muscle relaxing medications he was given very early on would be well worn off by now and he 100% meets the criteria for testing. I’m not sure how he didn’t meet the criteria to begin with tbh, as it’s never properly been released in detail.

I can't remember where I read that the doctors who were due to perform the brain stem testing ordered peripheral nerve testing, which he failed, so one part of the brain stem test couldn't be performed accurately as it would render that part 'non applicable'. Plus mum wouldn't sanction apnoea testing right way back when.

 

[nini01]

I think the staff looking after this boy (and extremely well given he's been technically dead for 3 months) must be so anxious of a cardiac episode over the coming days.

I've had an awful day, have got a touch of heat exhaustion but I wouldn't want to be on duty looking after Archie for any amount of pay right now.

You and me both it’s hard enough working with non picu and icu patients but in this situation never enough money and mht intervention