quote:

---

A European arrest warrant has been issued for the parents of a five-year-old boy with a brain tumour, missing from hospital since Thursday.

Ashya King was taken out of Southampton General Hospital by his mother and father against medical advice.

Hampshire Police believe he may have been taken to Spain and police are at a Marbella property owned by the family.

---

quote:

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Originally posted by Byron:
Right now it looks like a tragic misunderstanding between parents, hospital and prosecutors.

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quote:

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Originally posted by seekingsister:
So - should it be a crime to remove a loved one from hospital to pursue alternative medical treatment?

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quote:

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Originally posted by Zoey:
But surely the more sensible plan would have been to talk to the hospital about one's proposals i.e. we want to take our child to X medical facility in country Y in order to get Z treatment available there.

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quote:

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Originally posted by Zoey:
I wouldn't propose that Ashya's parents should lose custody of him and would be surprised if any social worker or member of medical staff is arguing that.

---

Moreover, if that were seriously being proposed by a state body, his parents would be entitled to free legal representation and I would be astounded if a court in England or Wales agreed to a care plan whereby they lost care of him on the basis of the facts as currently presented.

I know, I know - I said I'm ducking out and that is what I should do.
 

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Posted by Sioni Sais (# 5713) on :
 
Primarily, care for the child should be the parents responsibility. It looks like, at the very least, there was a breakdown in communications between the hospital and the parents, with everyone refusing to back down at which point the hospital seems to have called in the cavalry (in the form of the police).

I hope we don't decide future policy on the basis of this case, which looks a hard one, because hard cases make bad law . Leave the marginal ones to the judges.
 

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Posted by Eutychus (# 3081) on :
 
I apologise for the wrong terminology and erroneous legal conclusions (or at least implications I drew).

Among my longstanding local church friends I have a social worker who for a large part of her career has been involved in removing children from the care of their parents, and parents of children who have been removed from their care, so I can see this issue from both sides.

The fact remains that in this case, the parents say they got the distinct impression they would not be able to have access to their child if social services got involved and that this would happen if they persisted asking about alternative treatment options. I can understand that mindset even if they were mistaken, and I think this explains why they acted pre-emptively, even if opinion is divided as to whether they were justified in doing so.

I note the health trust is still talking in terms of a lack of consent on the part of the hospital, which sounds scary to me.

While this still looks like having indirect benefits for JWs, I wonder whether the family's reaction is coloured by a certain view of "The World"™.

(x-post)

[ 02. September 2014, 21:17: Message edited by: Eutychus ]
 

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Posted by Doublethink (# 1984) on :
 

quote:

---

Originally posted by Eutychus:
The family's view appears to be that the hospital was basically looking to experiment with radiotherapy despite proven risks. The child, they felt, was to be a guinea pig. Proton beam therapy results appear to be unconfirmed (no better or worse than radiotherapy) but at least do less collateral damage.

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quote:

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Originally posted by Doublethink:
Using radiotherapy to treat cancer is hardly experimental. Unconfirmed is not the same as equivalent.

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quote:

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Originally posted by Eutychus:

The fact remains that in this case, the parents say they got the distinct impression they would not be able to have access to their child if social services got involved and that this would happen if they persisted asking about alternative treatment options.

---

I wish they had got decent legal advice before doing a flit. It really doesn't sound as if they did. If social services become involved, in England and Wales, social services have a **duty** to promote contact between children who are Looked After by the state and members of their birth family. The contact must be in the best interests of the child - hence, if children are in permanent foster care and parents don't present appropriately at contact sessions then contact may stop being offered and, additionally, children in permanent foster care need to settle in that foster care, so contact with their birth parents may only be once every few months. However, whilst Care Proceedings are going on, social services in England and Wales have a legal duty to promote the relationship between a child who is subject to such proceedings and their birth family (usually offering supervised contact multiple times a week). Moreover, I continue to think that a court in England would almost certainly not approve a care plan for Ashya to be placed in foster care or away from the custody of his parents - I would expect the court to make a determination regarding what medical treatment is appropriate for him, but would expect everybody (social workers, court, etc) to see that, aside from the issue of what medical care is in his best interests, there is no question that his parents can care for him appropriately and meet his needs and are therefore the best people to do so.

(Thank you for your post, Eutychus. As you may have guessed, I'm a bit tetchy currently for reasons entirely unrelated to this thread and your first response to me wound me up somewhat. I'm grateful for your follow up.)
 

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Posted by Eutychus (# 3081) on :
 
And thanks for that. I agree that with different and better advice, they might have acted differently. But how hard it is in situations like this to know who will give you truly wise advice and who you can really trust.
 

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Posted by justlooking (# 12079) on :
 

quote:

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Originally posted by Caissa:
Parents have a duty of care. When they do not meet it, the state is obliged to intervene.

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quote:

---

Originally posted by Eutychus:

quote:

---

Originally posted by Doublethink:
Using radiotherapy to treat cancer is hardly experimental. Unconfirmed is not the same as equivalent.

---

I am not a doctor and I appreciate the problems with protocol by internet.

As I understand it, the family's arugment is that there is less collateral damage - especially in children - with proton therapy, the therapeutic outcomes of which are disputed.

Apart from the treatment options themselves, we also don't know enough about the child's prognosis to take an informed view. But if the family felt the side-effects of the proposed treatment greatly outweighed any uncertain benefits, and had assurances from another hospital of treatment with fewer side-effects, I can understand them wanting to exercise that option, and having trouble seeing why they shouldn't be allowed to.

In their case, meeting resistance from the hospital staff when this idea was raised probably strengthened, rather than lessened, their resolution.

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quote:

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Originally posted by no prophet:
.

As for vaccinations, the new policy here for health workers is either get a 'flu vaccine or when ordered to do so at work, wear proper protection to avoid getting infected or infecting others. I suspect that not being paid for sick days when it is the 'flu and you've not been vaccinated is also the consequence. My employees are told to get vaccinated (free for all here through medicare), and haven't had the issue of considering not paying them if ill with the 'flu.

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quote:

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Originally posted by LucyP:

quote:

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Originally posted by no prophet:
.

As for vaccinations, the new policy here for health workers is either get a 'flu vaccine or when ordered to do so at work, wear proper protection to avoid getting infected or infecting others. I suspect that not being paid for sick days when it is the 'flu and you've not been vaccinated is also the consequence. My employees are told to get vaccinated (free for all here through medicare), and haven't had the issue of considering not paying them if ill with the 'flu.

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This is a tangent, but - really, people don't get paid if they have "the flu"? I am pro-vaccination and have had the flu shot, but am under no illusions about its efficacy: approximately 60%.

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quote:

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AIUI, the oncologist responsible for treating Ashya believes that, for his particular tumour, there would be no difference in outcome between proton beam radiation and whatever the normal type of radiotherapy is. I do not know how much variation there can be in brain tumours nor how much detail the websites discussing proton beam therapy go into about the differences. The Czech hospital which had agreed to treat Ashya had apparently not seen any brain scans or medical records, so were hardly speaking from a position of knowledge of this particular tumour.

I also note that, according to Southampton Hospital, they had offered the family a second opinion and were prepared to discuss travelling abroad for proton beam therapy, possibly including applying for NHS funding to do so, as nearly 100 other children have done.

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quote:

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Originally posted by Caissa:
Parents have a duty of care. When they do not meet it, the state is obliged to intervene.

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quote:

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Originally posted by orfeo:

As things stand, the proposal to make this child a ward of the State sounds like a gross usurpation of the proper role of medical professionals.

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quote:

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Originally posted by seekingsister:
So - should it be a crime to remove a loved one from hospital to pursue alternative medical treatment?

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quote:

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Originally posted by no prophet:
Except that we already require people to go to school and get educated even if they don't want to be there.

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quote:

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Originally posted by L'organist:
The trouble is that because there is no facility for proton beam therapy (PBT) in the UK there will always be the suspicion that a decision that a treatment won't be recommended because it simply isn't available. At the moment UK patients who require PBT are sent to the US.

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quote:

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Originally posted by justlooking:

quote:

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Originally posted by orfeo:

As things stand, the proposal to make this child a ward of the State sounds like a gross usurpation of the proper role of medical professionals.

---

There is no proposal to make the child a ward of court, he was made a ward of court under a temporary order. Being a ward of court does not make the child a 'ward of the state', it means decisions will be authorised by a judge and, most importantly, it means the child will be represented independently of parents, doctors or social workers. The court has a duty to act in the child's best interests and to consider the situation from the child's viewpoint. In this case there was good reason to fear for Aysha's safety and therefore a duty to take whatever action was needed in order to locate him and ensure he was getting the care he needed.

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quote:

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Originally posted by justlooking:

quote:

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Originally posted by Caissa:
Parents have a duty of care. When they do not meet it, the state is obliged to intervene.

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Exactly. And in this case there was a temporary Wardship Order which made the child a ward of court.

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quote:

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Originally posted by Eutychus:

quote:

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Originally posted by justlooking:

quote:

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Originally posted by Caissa:
Parents have a duty of care. When they do not meet it, the state is obliged to intervene.

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Exactly. And in this case there was a temporary Wardship Order which made the child a ward of court.

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Not, I think, until after the parents had been arrested (without charge), and passed on the grounds that the parents were in custody.

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quote:

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Originally posted by justlooking:
When it comes to a dispute or when a child is seen to be in danger the court and legal system ensure the child's rights and interests take priority.

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quote:

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Originally posted by itsarumdo:
In child protection we now have an ATTITUDE that says - every adult is suspicious, is a potential child abiuser or is inadequate to make the correct decisions, because state child protection knows best, and only we are really safe. That attitude is corrosive - how can a world be safe for children if they get the message that all adults are dangerous? It is a lso a displacement of the state's position re its citizens - somehow the state's position as a dangerous guardian and parent that has to be watched and kept in check has been projected back at its citizens. The active abuse of children when they are in state protection - e.g. care homes - is a case in point - it's not that they represent a high proportion of the children abused, but rather like an airplane or a train crash, it all happens in one place and there should have been measures in place to prevent this in the first place. It's all very well making legislation to prevent abuse when under state protection, but that should apply to abuse FROM the state and its employees, NOT from potentially responsible adults. The state's administrative structures are ideal for infiltration by anyone who has criminal motives, and so the state should be prepared for that, one way or another. However, the legislation for private individuals should be different, and be based on the principle that most adults do not wish to harm children. Furthermore, it should be fairly extreme cases, where a clear boundary has been crossed which prompts the state to "save a child" by removing guardianship from its parents or normal family guardians. The threat of making the child a ward of court should the parents disagree with the doctors diagnosis or proposed treatment is the only reason this family took off in a car.

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quote:

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King said when he questioned the doctors' plans, they threatened to take Ashya away from him via a protection order.

"We couldn't take it anymore, not knowing and not being able to question anything," King said. "We couldn't be under that system anymore."

---

quote:

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Originally posted by bib:
We had a patient, a little 3 year old with leukaemia, whose parents were determined to take him home and feed him only sterile water as the mother had a dream that this would bring about a cure. The hospital prevented this from happening and the child eventually responded to proper medical treatment. Surely it would not have been ok for the parents to be allowed to carry out their plans as the child would have died. Would that be considered manslaughter?

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quote:

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Originally posted by itsarumdo:
The threat of making the child a ward of court should the parents disagree with the doctors diagnosis or proposed treatment is the only reason this family took off in a car.

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quote:

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If the NHS will not fund overseas treatment then they need to allow families to choose to withdraw from NHS care and pursue alternatives at medical centers that will provide them.

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quote:

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Originally posted by justlooking:
Eutychus - The police applied for an international arrest warrant because the child had been taken out of jurisdiction of the UK court. I don't see any other way of ensuring the French or Spanish police could act swiftly. Until the family were found there was no information about if or how they were caring for Aysha and meeting his medical needs.

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quote:

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Originally posted by Eutychus:
The UK police claimed they had implemented the European Arrest Warrant merely to give them the right to talk to the parents.

When the police caught up with the parents, they were not just "talked to". They were arrested, charged, and put in prison. Do you think that should happen every time the police want to "talk to" somebody?

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quote:

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Originally posted by justlooking:
The Spanish police arrested the parents and arranged for the child to be taken to hospital but did not charge the parents with any offence. They were held pending a decision about extradition but the UK then withdrew the arrest warrant.

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quote:

---

the legal action was sparked by the parents' action in removing Aysha from medical care without giving any information about where they were going and what arrangements they had for meeting his continued medical needs.

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quote:

---

Originally posted by Jane R:
If the NHS really can't fund your overseas treatment then you can try to raise the money yourself - some parents have set up charities to raise the money for their children to have treatment abroad, and as far as I am aware the NHS was very supportive of them. But they didn't rush out of the country with their sick child in tow without telling the hospital what they were doing.

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quote:

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Originally posted by justlooking:
orfeo - the reason to fear for the child's safety was his need for specialised medical care which included being fed via a tube. In the absence of any information about how his parents intended to ensure his continued care and safety it seems reasonable to me that action was taken immediately to find him and make sure he was safe.

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quote:

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.....in the absence of any information the worst was presumed.

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quote:

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But given that Hampshire police have established that what the parents did is not illegal, why do they have to tell the hospital anything?

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quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by justlooking:
orfeo - the reason to fear for the child's safety was his need for specialised medical care which included being fed via a tube. In the absence of any information about how his parents intended to ensure his continued care and safety it seems reasonable to me that action was taken immediately to find him and make sure he was safe.

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You've just reiterated one of my chief objections here - in the absence of any information the worst was presumed.

Again, I don't see any information about these parents that would justify presuming the worst about them, that they were anti-scientific kooks or reckless as to their child's welfare.

Nor, as seekingsister has pointed out, was there any justification for thinking that his parents were taking him out of reach of the medical care that he needed. He is now doing just as well in a Spanish hospital as he was doing in an English one.

---

quote:

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Originally posted by Jane R:
But I can understand why Southampton Hospital was reluctant to spend thousands of pounds on proton beam therapy if it is not significantly more effective than conventional radiotherapy.

---

quote:

---

Especially if Mr King's claim that they threatened him with a protection order if he continued to ask for a transfer to a proton therapy clinic is true.

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Is there any evidence that this is true, beyond Mr King's own assertion?

Given that he openly contacted the Prague Centre on 20 August, it does seem that something happened for the family to switch from aiming for a managed hospital transfer to reckless flight.

I think this is the crux of the whole matter. If the family originally sought a managed hospital transfer and had a property which they could sell to finance treatment themselves, what made them sneak Ashya out of hospital and flee?
 

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Posted by Jane R (# 331) on :
 
Who knows? Maybe the staff at Southampton Hospital said something that was misinterpreted. Maybe they thought Ashya was getting worse and time was running out. Maybe they had a buyer interested in their Spanish property and couldn't bear to be separated from each other while the property sale was going through.

What does seem clear is that everyone concerned was trying to do what they thought was best for Ashya.
 

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Posted by Margaret (# 283) on :
 

quote:

---

Originally posted by North East Quine:
If the family originally sought a managed hospital transfer and had a property which they could sell to finance treatment themselves, what made them sneak Ashya out of hospital and flee?

---

quote:

---

Originally posted by Erroneous Monk:

quote:

---

Originally posted by Jane R:
But I can understand why Southampton Hospital was reluctant to spend thousands of pounds on proton beam therapy if it is not significantly more effective than conventional radiotherapy.

---

I imagine the doctors were also reluctant to see the parents spend the kind of money involved in getting that treatment privately, since they genuinely believed the outcome would be no different.

---

quote:

---

Originally posted by orfeo:
I stand corrected on my misuse of terminology. However...

What good reason to fear for his safety?

---

quote:

---

They clearly didn't think he had been abducted by a stranger. That's inconsistent with referring to his parent's intentions and obtaining an arrest warrant for his parents.

And I haven't seen the slightest bit of evidence that his parents were considered a danger to him.

---

quote:

---

There's no suggestion that I've seen that they were abusive, violent, failed to provide him with food or shelter, or anything else that would suggest a child is 'at risk'.

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quote:

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No, the sole basis for "fearing for his safety" is that his parents wanted a different medical treatment in a different location.

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quote:

---

The implications are pretty staggering. What's next? What happens to adults who say they want a second opinion?

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quote:

---

I wouldn't be surprised if what the hospital said to the police was "THEY'VE TAKEN HIM OUT OF TREATMENT!". Because if they'd added "to take him to different treatment", the cause for alarm would have evaporated.

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quote:

---

There is absolutely no fear for the safety of a child involved in switching doctors.

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quote:

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I'm not required to consult my GP or optometrist before trying a different GP or optometrist, any more than I'm obliged to notify my hairdress or gardener.

---

quote:

---

Originally posted by Jane R:
....

The basic principle in UK law is that children are not the property of their parents, and their right to appropriate medical treatment trumps their parents' right to practice their religion. Teenagers might be allowed to refuse medical treatment if they are considered mature enough to understand the implications, even if they are underage; five-year-olds would not be, although a court would be expected to consult them before coming to a final decision.

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quote:

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Originally posted by Justinian:
You're seriously asking what good reason there is to fear for the safety of a patient who needs continual medical care and is not returned to any hospital at all?

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quote:

---

Originally posted by orfeo:
To put it another way, there isn't any evidence of child endangerment. If there was, the legal action wouldn't have been dropped.

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quote:

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Originally posted by Doublethink:
Well except for the fact that the Telegraph is reporting his transfer back is now being delayed by medical issues (not not treatment choice.)

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quote:

---

To put it another way, there isn't any evidence of child endangerment. If there was, the legal action wouldn't have been dropped.

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quote:

---

Originally posted by Jane R:
Someone with no religious objections to radiotherapy might still want proton beam therapy because they don't believe the doctors' assurances that it isn't any more effective than conventional radiotherapy.

---

quote:

---

Originally posted by Jane R:
orfeo:

quote:

---

To put it another way, there isn't any evidence of child endangerment. If there was, the legal action wouldn't have been dropped.

---

It looks to me as if the legal action has been dropped partly as a result of the Internet outcry (mob rule, don't you just love it?)

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quote:

---

Originally posted by Doublethink:
Seriously, how do you think you monitor intercranial pressure in a family car ? He initially went into a high dependency unit in Malaga - that is only one step down from Intensive Care,

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quote:

---

Originally posted by Gracie:

quote:

---

Originally posted by Jane R:
Someone with no religious objections to radiotherapy might still want proton beam therapy because they don't believe the doctors' assurances that it isn't any more effective than conventional radiotherapy.

---

Except here the issue for the parents as stated by them was not the effectiveness of one treatment over the other, but rather the perceived devastating side effects of conventional radiotherapy compared to those potentially caused by proton bean therapy.

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quote:

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A 2009 systematic review found that "No comparative study reported statistically significant or important differences in overall or cancer-specific survival or in total serious adverse events."[1][2]

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quote:

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Two prominent examples are pediatric neoplasms (such as medulloblastoma) and prostate cancer. In the case of pediatric treatments, a 2004 review gave theoretical advantages but did not report any clinical benefits.[18][19]

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quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Jane R:
orfeo:

quote:

---

To put it another way, there isn't any evidence of child endangerment. If there was, the legal action wouldn't have been dropped.

---

It looks to me as if the legal action has been dropped partly as a result of the Internet outcry (mob rule, don't you just love it?)

---

The majority is not always wrong.

---

quote:

---

Originally posted by Justinian:

quote:

---

Originally posted by Doublethink:
Seriously, how do you think you monitor intercranial pressure in a family car ? He initially went into a high dependency unit in Malaga - that is only one step down from Intensive Care,

---

This.

For those who aren't aware, Intensive Care is for the most ill patients in the hospital. It's the scary, sterile place with the ventilators. And by British standards it has a ratio of one nurse to one patient at almost all times. The only difference HDU has from Intensive Care is that it's one nurse to about two patients rather than one to one. (Indeed HDU is often put in the same ward as Intensive Care).

That was the medical decision the Spanish hospital made as soon as he was admitted. Not the English one. One specialist nurse to two patients. If you need HDU then the feeding tube is just the tip of the iceberg - it's just a particularly obvious means of saying things.

Given that the Spanish didn't just admit him, they put him straight into the second most intensively nursed (and expensive) area they had, they definitely thought he had an urgent problem that needed intensive nursing. And hadn't been taken to another hospital.

(By American standards where he went would be termed Level II PICU.)

---

quote:

---

Originally posted by Matt Black:
Whilst it does seem that the PTB overreacted after the removal from the hospital - and possibly before - someone raised the question on page 1 as to why it was apparently necessary for the both parents, plus Ashya, to go to Spain for apparently the sole purpose of selling a property. I can understand them removing him to take him to Prague, but this is the part on the parents' side that makes no sense to me.

---

quote:

---

Originally posted by Doublethink:
Well this is where I got the transfer information from.

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quote:

---

Originally posted by Doublethink:
And Prague are of course totally unbiased ? And have full access to all medical information about the case now ? Because previously they were giving an opinion without that information.

---

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Doublethink:
Well this is where I got the transfer information from.

---

The impression I get from the relevant paragraph isn't the one that I got from your post.

And why did Southampton only get in touch with Prague on Monday? Why such a delay from 20 August?

Again, I come back to the point I was making earlier: doctors are entirely correct in giving their professional opinion about the best course of treatment. But it is not the role of doctors to control the flow of alternative information. If the clinic in Prague told the family that they would consider treatment but needed documentation first (which appears to be confirmed by the clinic), then it is completely inappropriate for anyone in Southampton to stand in the way of that documentation being provided.

The fact that THEY don't think Prague would offer a better treatment is irrelevant. The family have the right to make that decision themselves, and to be informed by Prague's opinion. It would be a very different situation if Prague said "no, he is not suitable for our treatment", but that hadn't happened.

---

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Matt Black:
Whilst it does seem that the PTB overreacted after the removal from the hospital - and possibly before - someone raised the question on page 1 as to why it was apparently necessary for the both parents, plus Ashya, to go to Spain for apparently the sole purpose of selling a property. I can understand them removing him to take him to Prague, but this is the part on the parents' side that makes no sense to me.

---

One can only speculate as to whether they'd have done the same without the perception that their wishes were being ignored and/or overridden.

Assuming that's genuinely their perception of course. But I do think that if they really believed there was going to be some kind of legal action to enforce the hospital's treatment, they wouldn't leave him in the hospital while making visible steps towards their own preferred treatment.

In their eyes, that might've been a move that could trigger a hospital response just as much as what they actually did.

---

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Doublethink:
And Prague are of course totally unbiased ? And have full access to all medical information about the case now ? Because previously they were giving an opinion without that information.

---

What opinion did they give before? As far as I can see they said they wanted further information about the boy's condition.

As to totally unbiased: maybe no-one is totally unbiased. There's no evidence to show that Prague is more biased than Southampton. There's nothing wrong with 2 medical establishments both offering a treatment plan for a patient and saying "we think this is the best option". There's only something wrong with one of those establishments saying "if you pick the other plan, we'll get a court order".

---

quote:

---

Originally posted by Doublethink:
The court order doesn't mean the hospital get to choose the treatment, it means the case goes to legal arbitration basically. With an independent legal guardian for the child.

---

quote:

---

Originally posted by Matt Black:
Why/ how would the hospital have found out that one of them had gone to Spain? Hordes of Brits go to Spain each summer.

---

quote:

---

Originally posted by Doublethink:

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Doublethink:
Well this is where I got the transfer information from.

---

The impression I get from the relevant paragraph isn't the one that I got from your post.

And why did Southampton only get in touch with Prague on Monday? Why such a delay from 20 August?

Again, I come back to the point I was making earlier: doctors are entirely correct in giving their professional opinion about the best course of treatment. But it is not the role of doctors to control the flow of alternative information. If the clinic in Prague told the family that they would consider treatment but needed documentation first (which appears to be confirmed by the clinic), then it is completely inappropriate for anyone in Southampton to stand in the way of that documentation being provided.

The fact that THEY don't think Prague would offer a better treatment is irrelevant. The family have the right to make that decision themselves, and to be informed by Prague's opinion. It would be a very different situation if Prague said "no, he is not suitable for our treatment", but that hadn't happened.

---

Well firstly he had a second surgery on the 22nd of August, so I am guessing the medical team might have been wanting to see him stabilise post-operatively before being able to assess accurately what to do next, or for that matter to be able to provide current medical information to Prague.

Press reports suggest that Prague have been sent his MRI scans. But if he had brain surgery on the 22nd of August, there would little point in sending such scans until there was a enough post-op recovery to show clearly what they would be working with.

---

quote:

---

Originally posted by Matt Black:
I don't think that kind of reasoning would have stood up to scrutiny by a Family Court judge.

---

quote:

---

Originally posted by orfeo:
Obviously we don't know exactly what was said, but currently the Kings are saying that the perception they got was that the doctors would take legal action to enforce their treatment plan.

No-one should have ever suggested such a thing. The law is only supposed to be there to step in when parents are acting entirely outside reasonable bounds, not when they are making a choice which is within the bounds of reasonableness. Opting for another medical treatment might not be what the doctors in Southampton recommended, but that's not the right question.

---

quote:

---

Originally posted by orfeo:
As for 'secrecy': Where's the obligation to give the hospital information? Given all the things that the hospital seems to have successfully worked out (he's gone, his parents have him, they have a feeding system, they want to take him to another clinic), what exactly were the parents supposed to tell the hospital?

The scenario as currently presented doesn't really have the hospital in the dark about much. The main thing missing is an opportunity for the hospital to act to prevent the child's removal. That's not a piece of information.

---

quote:

---

Originally posted by justlooking
But UK law treats children as having rights and interests independent of their parents or of state authorities. When it comes to a dispute or when a child is seen to be in danger the court and legal system ensure the child's rights and interests take priority.

---

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Doublethink:

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Doublethink:
Well this is where I got the transfer information from.

---

The impression I get from the relevant paragraph isn't the one that I got from your post.

And why did Southampton only get in touch with Prague on Monday? Why such a delay from 20 August?

Again, I come back to the point I was making earlier: doctors are entirely correct in giving their professional opinion about the best course of treatment. But it is not the role of doctors to control the flow of alternative information. If the clinic in Prague told the family that they would consider treatment but needed documentation first (which appears to be confirmed by the clinic), then it is completely inappropriate for anyone in Southampton to stand in the way of that documentation being provided.

The fact that THEY don't think Prague would offer a better treatment is irrelevant. The family have the right to make that decision themselves, and to be informed by Prague's opinion. It would be a very different situation if Prague said "no, he is not suitable for our treatment", but that hadn't happened.

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Well firstly he had a second surgery on the 22nd of August, so I am guessing the medical team might have been wanting to see him stabilise post-operatively before being able to assess accurately what to do next, or for that matter to be able to provide current medical information to Prague.

Press reports suggest that Prague have been sent his MRI scans. But if he had brain surgery on the 22nd of August, there would little point in sending such scans until there was a enough post-op recovery to show clearly what they would be working with.

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Fair enough. And it may well be that there was some miscommunication with the parents over the willingness of Southampton to talk to Prague.

I would note, though, that the Telegraph article you linked to describes the Southampton hospital as executing a U-turn, from "he's getting the best possible care and proton beam therapy won't help" one day, to "we're talking to Prague" the next day. The earlier statements don't really seem to convey an idea that the issue was needing to wait before sending information, they seem more along the lines of having decided there was no need to send information.

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quote:

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Originally posted by Doublethink:
I think that the the headline is misleading given the content of the article.

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quote:

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Originally posted by orfeo:
And why did Southampton only get in touch with Prague on Monday? Why such a delay from 20 August?

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quote:

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But it is not the role of doctors to control the flow of alternative information. If the clinic in Prague told the family that they would consider treatment but needed documentation first (which appears to be confirmed by the clinic), then it is completely inappropriate for anyone in Southampton to stand in the way of that documentation being provided.

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quote:

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The fact that THEY don't think Prague would offer a better treatment is irrelevant. The family have the right to make that decision themselves, and to be informed by Prague's opinion.

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quote:

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Originally posted by Justinian:
And if a journalist pretending to be a clinic in Prague phoned up and asked for the infomation? What then?

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quote:

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Originally posted by orfeo:

quote:

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Originally posted by Justinian:
And if a journalist pretending to be a clinic in Prague phoned up and asked for the infomation? What then?

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Maybe we can wait until that actually happens to find out. I'm not going to speculate on slippery slope bogeymen ideas like this.

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quote:

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Originally posted by Justinian:

quote:

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Originally posted by orfeo:

quote:

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Originally posted by Justinian:
And if a journalist pretending to be a clinic in Prague phoned up and asked for the infomation? What then?

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Maybe we can wait until that actually happens to find out. I'm not going to speculate on slippery slope bogeymen ideas like this.

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Or maybe we can obey the law that was put in place for a depressingly common thing - and not blame the hospital for not breaking the law.

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quote:

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Originally posted by orfeo:

quote:

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Originally posted by Justinian:

quote:

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Originally posted by orfeo:

quote:

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Originally posted by Justinian:
And if a journalist pretending to be a clinic in Prague phoned up and asked for the infomation? What then?

---

Maybe we can wait until that actually happens to find out. I'm not going to speculate on slippery slope bogeymen ideas like this.

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Or maybe we can obey the law that was put in place for a depressingly common thing - and not blame the hospital for not breaking the law.

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You seem to be missing the fact that the parents were around for at least a week between contacting Prague and leaving the hospital. Your proposition that it wasn't possible to obtain the parent's consent makes no sense. This isn't something that only arose after they left the UK.

Surely you're aware that I, of all people, wouldn't advocate breaking the law!

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quote:

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Originally posted by 3M Matt:
The state are swallowing us all up. Particularly in regards to child care.

They want to lower the age that children start school. They want to make the school day longer and longer.

Why? Because they want the children in the hands of the state MORE and in the hands of their parents LESS, because then they can exert more control over the kind of people they turn out to be.

Paranoid? Possibly, but it's a hypothesis that fits the facts.

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quote:

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Originally posted by Doublethink:

quote:

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Originally posted by Gracie:
Except here the issue for the parents as stated by them was not the effectiveness of one treatment over the other, but rather the perceived devastating side effects of conventional radiotherapy compared to those potentially caused by proton bean therapy.

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What evidence there is, doesn't suggest much if any difference and that evidence is not very strong see here

quote:

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A 2009 systematic review found that "No comparative study reported statistically significant or important differences in overall or cancer-specific survival or in total serious adverse events."[1][2]

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quote:

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Two prominent examples are pediatric neoplasms (such as medulloblastoma) and prostate cancer. In the case of pediatric treatments, a 2004 review gave theoretical advantages but did not report any clinical benefits.[18][19]

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quote:

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Originally posted by Belle Ringer:
Once the parents were located, they could have been talked to instead of hauled into jail, hear their concerns. Even if arrested they could have been allowed at their son's bed under guard instead of preventing him from seeing them. [...]

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quote:

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Speaking about the family's relationship with doctors in Southampton, Mr King said: "They threatened me previously. When I asked about his cancer... they said if I ask anymore questions the right for me to make a decision will be taken away from me because they get immediate courts paper to say that they have right over my child.

"I had so much fear to mention anything to them because they could have stopped my son getting any treatment and just forcing this very strong treatment on him.

"So from that moment on I had to keep everything quiet."

Dr Pete Wilson, chief paediatrician at Southampton General Hospital, said doctors had told the family they believed proton beam therapy had "no benefit" but had still agreed to refer him for the treatment to be paid by the family and were in the process of helping them down this route.

He also denied any threats were made, adding: "When they [doctors] were asked directly by the family what would happen if they refused treatment, any treatment, they were told that in exceptional circumstances, as doctors, we would need to act in Ashya's best interests and that may need going to the court.

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quote:

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Originally posted by Gracie:

quote:

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Originally posted by Doublethink:

quote:

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Originally posted by Gracie:
Except here the issue for the parents as stated by them was not the effectiveness of one treatment over the other, but rather the perceived devastating side effects of conventional radiotherapy compared to those potentially caused by proton bean therapy.

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What evidence there is, doesn't suggest much if any difference and that evidence is not very strong see here

quote:

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A 2009 systematic review found that "No comparative study reported statistically significant or important differences in overall or cancer-specific survival or in total serious adverse events."[1][2]

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quote:

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Two prominent examples are pediatric neoplasms (such as medulloblastoma) and prostate cancer. In the case of pediatric treatments, a 2004 review gave theoretical advantages but did not report any clinical benefits.[18][19]

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The texts you quote do not talk about the comparative side effects at all.

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quote:

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Originally posted by Belle Ringer:
One article I read (I admit only one mentioned it) said the parents had been told by the doctors their son has only 4 months to live. If that's true I am totally on their side, nothing to lose possibly everything to gain in changing treatments, with or without permission.

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quote:

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Originally posted by Doublethink:

quote:

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Originally posted by Belle Ringer:
One article I read (I admit only one mentioned it) said the parents had been told by the doctors their son has only 4 months to live. If that's true I am totally on their side, nothing to lose possibly everything to gain in changing treatments, with or without permission.

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The telegraph article I cited some posts ago gives a life expectancy of three months - without further treatment.

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quote:

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a young lad who has a very, very good chance of survival if he receives rapid treatment. (source)

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Ashya is required to undergo two cycles of chemotherapy before he could be treated in Prague.

That is expected to take several weeks but afterwards Ashya would be able to travel to the Czech Republic.

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quote:

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"When [the doctors] were asked directly by the family what would happen if we refused any treatment they were told that in exceptional circumstances, as doctors, we would need to act in Ashya's best interests and that may need going to the court.

"[A threat] wasn't made. A question was asked what would happen if we refused treatment.

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quote:

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Originally posted by Doublethink:
A "serious adverse event" would be a serious side effect. Plus you need to read the whole article.

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quote:

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Originally posted by Gracie:
I don't get the impression from listening to Mr King that he got his information from Wikipedia.

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quote:

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Originally posted by Justinian:
This recent update leads to an obvious question:

If the kid has months to live without treatment, and will probably survive with treatment, and the parents refuse to let the kid receive treatment, should the parents have the right to let their kid die?

My answer is "Fuck, no. That's murder by neglect."

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quote:

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Originally posted by Zacchaeus:
Hindsight is a wonderful thing.

A very sick child disappeared, a week after an operation, without information as to where he was, what was going to happen to him and what provision for his ongoing care were in place. Even Ashya’s grandmother did not know what was happening.

At the time of his disappearance the hospital got flack for waiting 6 hours before reporting him missing.

We now know what happened, but it still remains his parent took him on an arduous journey by boat and car while he was very ill. I have done the journey to Spain by boat and car and it is not easy even for a healthy adult.

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quote:

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Originally posted by Zacchaeus:
Hindsight is a wonderful thing.

A very sick child disappeared, a week after an operation, without information as to where he was, what was going to happen to him and what provision for his ongoing care were in place. Even Ashya’s grandmother did not know what was happening.

At the time of his disappearance the hospital got flack for waiting 6 hours before reporting him missing.

We now know what happened, but it still remains his parent took him on an arduous journey by boat and car while he was very ill. I have done the journey to Spain by boat and car and it is not easy even for a healthy adult.

And the end destination of that journey was not treatment for Ashya, treatment is still another 1300 miles away across Europe.

Erm I can see why authorities are concerned about him and want to make sure he gets care…

What that care will be has not been specified, but it concerns me about the parents state of mind and understanding of what is being said to them.

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quote:

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Originally posted by orfeo:
...

We seem to have a cycle whereby public/media outrage that something wasn't done in a particular case leads to a determination to be seen to be doing something in every case. The fear of being seen to be inactive is far greater than the fear of doing the wrong thing. That's precisely why you get heavy-handed responses - because being seen to do something becomes more important than working out the best thing to do.

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quote:

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Originally posted by seekingsister:

But the question still remains, given that the Southampton police have said they broke no laws in taking the child out of the hospital in the first place:

1. Why was a European arrest warrant issued instead of a general Europe-wide alert to find the family and ensure the health of the child?

2. Why were the parents arrested, jailed, and separated from the child?

It's one thing to claim that the hospital was only concerned for Ashya's life, but the response was nonetheless excessive.

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quote:

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Originally posted by Zacchaeus:
When a child’s health is at stake they cannot afford to make ‘reasoned inferences’ they have to be certain. The hospital have the obligation to be certain the child is being looked after.

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quote:

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Originally posted by justlooking:
They broke no laws in taking the child out of hospital but their actions gave rise to justifiable fear for the child and the hospital would have been in breach of its legal obligations if it had taken no action.

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Originally posted by itsarumdo:
I'm sorry, but as soon as "child" is mentioned, there seems to be this all embracing desperate lavender fragrant panic that says "we must do everything". it's a CHILD!!!!!!!!

A child is not some entity on its own - it is part of a family, and there is a natural order of responsibility and authority. The state, the doctors, should come second to that natural order unless it's really really really awry. The lavender and hysteria make it so that a proportionate sense of what is reasonable and that the parents are the childs first primary guardians - have already flown out of the window and are nesting in a tree down the road.

In psychotherapy there is a principle of "good enough" parents - because very few parents have the continuous day by day wherewithal to hang it together through all stages of pregnancy through to adulthood that gives an optimum family life. There is therefore a generational guilt that passes down which is most visible in new mums that says "whatever I do is never good enough". This is the basis of the hysteria that creates these unbalanced decisions. Good enough.

The doctors - in fact - anyone - only have these rights of guardianship transferred if the parents transfer them for some reason - either they wilfully an unmistakably and *repeatedly* abuse the child, or they pass over responsibility voluntarily because they decide that person/organisation is far better resourced to deal with what is happening - for a defined period of time. And I say "repeatedly", because "good enough" means the right to seriously screw up and not be permanently branded by that action or judged by others. We already judge ourselves far too much.

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quote:

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Originally posted by orfeo:
But it is simply wrong to equate wanting a different treatment with 'refusal to let the kid receive treatment'. This is clearly NOT a case of refusing to let a kid be treated. Refusal of a particular treatment is not refusal of treatment. Not unless there is no other treatment is available.

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quote:

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From The Father:
"When they [doctors] were asked directly by the family what would happen if they refused treatment, any treatment, they were told that in exceptional circumstances, as doctors, we would need to act in Ashya's best interests and that may need going to the court."

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quote:

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Originally posted by orfeo:
ADDENDUM: And I do note your claim about taking a child away from "any practical treatment". This again has the flavour of depicting continental Europe as some kind of wasteland devoid of decent medical care.

I simply don't buy this proposition that this child was doomed if he was anywhere other than a particular hospital in Southampton.

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quote:

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Originally posted by orfeo:
How so?

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after?

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quote:

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Is there some sort of roving duty of care in relation to all children in the area?

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quote:

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I don't think this obligation you are claiming exists. I think a hospital has an obligation to its patients. I don't think it follows that someone who is a patient continues to be a patient. I don't think it follows that termination of the patient/doctor relationship requires the doctor's consent.

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quote:

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Originally posted by Enoch:
I'm tending to agree with what Orfeo has been saying on this, even though he's thousands of miles away.

However, I'm also tending to suspect that most of our reactions to this sad story are driven by which side we instinctively come down on in respect of a quite different question.
Do we instinctively trust authority figures, experts etc, believe they know best, and act with public spirited integrity until demonstrated otherwise, or are we instinctively suspicious of them? Do we give them the benefit of the doubt, or don't we?

I know that my deep seated instinctive preference for the latter side of that fence is influencing me when I say that, knowing the UK's box-ticking, back-watching, blame-diverting official culture, I tend to assume that the Southampton Hospital feels affronted by a family that hasn't done what it was told and that both the Hospital and the local Police are driven as much by fear of being held responsible à la Baby P etc and being named and shamed by the gutter press if they didn't go over the top and the poor boy died, as by genuine concern for a sick child.

But as I say, I know my reaction is as much influenced by which side of that other fence I instinctively find myself, as by an objective evaluation of this case. I suspect the same is also true of those who leap to defend the Hospital and the Police.

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quote:

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Originally posted by Justinian:

quote:

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Originally posted by orfeo:
How so?

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after?

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Does your nephew have four months to live if they are not treated?

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quote:

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Originally posted by quetzalcoatl:
As well as the idea of good enough parents, therapists also sometimes talk about bad enough parents. This is an interesting idea, meaning that perfect parents would really screw you up. A bit like the oyster and the grit, children need a bit of frustration and bad behaviour by parents; something to get their teeth into. And yes, it is a great boon to psychiatrists and therapists in later life.

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quote:

---

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after? Is there some sort of roving duty of care in relation to all children in the area?

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quote:

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Originally posted by Justinian:
On the other hand kids are not the property of their parents. Parents do not have the right to kill their children. Had this been an adult recklessly endangering themself rather than a child being recklessly endangered by their parents the response would have been very different.

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quote:

---

Originally posted by orfeo:

quote:

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Originally posted by Justinian:

quote:

---

Originally posted by orfeo:
How so?

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after?

---

Does your nephew have four months to live if they are not treated?

---

Who knows? Maybe someone should go around to his house and check.

You still seem to proposing, in the next paragraph of your response, that a hospital automatically has an obligation towards anyone (or at least, anyone under the age of 18?) in the area who is terminally ill. Again I would question that. It would involve a pro-active duty of a hospital to go out and seek the terminally ill, not wait for them to come and ask for help.

Obligations arise from relationships. A hospital has an obligation to its patients. The patient relationship can be terminated.

It seems fairly clear to me that the parents, by their actions, were terminating the patient relationship. I would fully accept that the hospital had obligations towards the boy while they were treating him, but there seems to be this unstated assumption that they were still treating him. I don't think that assumption stands up very well to proper examination.

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quote:

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Originally posted by North East Quine:
Originally posted by orfeo:

quote:

---

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after? Is there some sort of roving duty of care in relation to all children in the area?

---

Pretty much. The hospital check that, for example, if the parents are taking their newborn baby home by car, they are doing so in a properly fitted car seat. You can't just waltz out of hospital and put a baby in an unsecured carrycot on the back seat. Not here, anyway.

Once you're home, there are follow-up visits by a midwife, and then by a health visitor. Plus you're expected to show up regularly to have your baby weighed at a clinic. I'm not sure at what point alarm bells would start ringing if you kept your baby away from all health professionals, but it would happen at some point.

Also (voice of bitter experience) if your child hasn't been fully vaccinated (because your child had an adverse reaction to the first vaccination and your GP refused to give the second, and this is fully documented on your child's medical records) there are reassessments every few years of your child's not-fully-vaccinated status.

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quote:

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Originally posted by Matt Black:
The healthcare service here has an ongoing responsibility to children and other legally vulnerable individuals, whether or not in hospital, hence the visits given as examples by North East Quine above. That relationship does not automatically terminate on discharge from hospital.

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quote:

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Originally posted by orfeo:
It is also relevant some case where the prosecution hasn't said "oh dear, there's absolutely no prospect of a conviction for child endangerment".

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quote:

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Originally posted by North East Quine:
Pretty much. The hospital check that, for example, if the parents are taking their newborn baby home by car, they are doing so in a properly fitted car seat. You can't just waltz out of hospital and put a baby in an unsecured carrycot on the back seat. Not here, anyway.

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quote:

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Originally posted by Justinian:
Why do you expect the hospital to be telepathic?

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quote:

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Originally posted by orfeo:

quote:

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Originally posted by Justinian:
Why do you expect the hospital to be telepathic?

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I don't. I also don't expect them to ignore the fact that the parents had the presence of mind to take a feeding tube with them.

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quote:

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Originally posted by Justinian:

quote:

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Originally posted by orfeo:

quote:

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Originally posted by Justinian:
Why do you expect the hospital to be telepathic?

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I don't. I also don't expect them to ignore the fact that the parents had the presence of mind to take a feeding tube with them.

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Feeding the patient is not a cancer treatment.

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quote:

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I don't suppose you have any references to legislation handy?

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quote:

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Originally posted by Matt Black:
The healthcare service here has an ongoing responsibility to children and other legally vulnerable individuals, whether or not in hospital, hence the visits given as examples by North East Quine above. That relationship does not automatically terminate on discharge from hospital.

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quote:

---

Originally posted by North East Quine:
Originally posted by orfeo:

quote:

---

Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after? Is there some sort of roving duty of care in relation to all children in the area?

---

Pretty much. The hospital check that, for example, if the parents are taking their newborn baby home by car, they are doing so in a properly fitted car seat. You can't just waltz out of hospital and put a baby in an unsecured carrycot on the back seat. Not here, anyway.

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quote:

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Originally posted by North East Quine:
Originally posted by orfeo:

quote:

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I don't suppose you have any references to legislation handy?

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This is a Scottish government publication. See the box on page 10.

I assume the position in the rest of the UK is the same or broadly similar.

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quote:

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Originally posted by orfeo:

Obligations arise from relationships. A hospital has an obligation to its patients. The patient relationship can be terminated.

It seems fairly clear to me that the parents, by their actions, were terminating the patient relationship. I would fully accept that the hospital had obligations towards the boy while they were treating him, but there seems to be this unstated assumption that they were still treating him. I don't think that assumption stands up very well to proper examination.

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quote:

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Originally posted by orfeo:
Agreed. And?

Here's the disconnect I'm feeling right now with this 'child endangerment' argument that is currently running: where's the urgency? Where's the need to have court orders and arrest warrants within a single day?

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quote:

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A belief that the parents would withhold cancer treatment may well justify action, but it does not justify we-have-to-find-him-right-now emergency-order action.

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quote:

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Originally posted by JoannaP:

quote:

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Originally posted by orfeo:

Obligations arise from relationships. A hospital has an obligation to its patients. The patient relationship can be terminated.

It seems fairly clear to me that the parents, by their actions, were terminating the patient relationship. I would fully accept that the hospital had obligations towards the boy while they were treating him, but there seems to be this unstated assumption that they were still treating him. I don't think that assumption stands up very well to proper examination.

---

Surely a doctor-patient relationship can only be terminated by one of the participants? The parents are not the patient and so do not have the right to terminate the relationship unilaterally.

Also, they did not terminate the relationship; they just removed Ashya from the hospital without providing any notice. Had they tried to discharge him or asked for him to be transferred to another hospital it would be different and the hospital would know that its duty of care had ended (assuming this was allowed to happen and Ashya was not made a ward of court).

According to your logic, when my grandmother, who was suffering from Alzheimer's, wandered out of the hospital after the hip replacement op and somehow managed to find her way home, she should have been allowed to stay home, having left her clothes, medication, etc. etc. in the hospital. At least she left the hospital under her own steam, which was more than Ashya did.

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quote:

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Originally posted by JoannaP:
Surely a doctor-patient relationship can only be terminated by one of the participants? The parents are not the patient and so do not have the right to terminate the relationship unilaterally.

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quote:

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Originally posted by Gee D:
And surely rights of guardianship of a child only leave the parents if there is a court order to that effect. The proper course for the hospital to take would have been to make an application to the relevant court for an order declaring the child a ward of the court or of the state. Courts here regularly consider applications for such an order when a child of JW parents is said to need a blood transfusion. A court will only make an order if it is satisfied that the treatment is necessary. Now Ashya is out of the UK, that may very well not be possible for such an application to be made. In the absence of an order it's hard to see that the parents her have committed any offence.

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quote:

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Originally posted by Moo:

quote:

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Originally posted by JoannaP:
Surely a doctor-patient relationship can only be terminated by one of the participants? The parents are not the patient and so do not have the right to terminate the relationship unilaterally.

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Did they have the right to initiate the relationship unilaterally?

Moo

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How can anyone unilaterally initiate a relationship??
 

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Posted by la vie en rouge (# 10688) on :
 

quote:

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Originally posted by orfeo:
Children of that age have no capacity to enter into a doctor/patient relationship, and so they also lack the capacity to end it. Their parents make those decisions.

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quote:

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Originally posted by orfeo:
Your argument is lacking in logic. How did the doctor/patient relationship arise in the first place? Did Ashya create it?

No. Children of that age have no capacity to enter into a doctor/patient relationship, and so they also lack the capacity to end it. Their parents make those decisions.

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quote:

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Originally posted by orfeo:
Your argument is lacking in logic. How did the doctor/patient relationship arise in the first place? Did Ashya create it?

No. Children of that age have no capacity to enter into a doctor/patient relationship, and so they also lack the capacity to end it. Their parents make those decisions.

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quote:

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Originally posted by Moo:

quote:

---

Originally posted by JoannaP:
Surely a doctor-patient relationship can only be terminated by one of the participants? The parents are not the patient and so do not have the right to terminate the relationship unilaterally.

---

Did they have the right to initiate the relationship unilaterally?

Moo

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quote:

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11. If a parent / legal representative requests to discharge a child from hospital contrary to medical advice, the Hospital Team should consider whether such an action is potentially harmful to a child’s welfare and of
immediacy as to require the initiation of statutory intervention to preclude such a course of action. Where immediate statutory intervention is considered to be necessary, Child Protection Procedures should be initiated and hospital staff should refer the child to Social Services with a view to the initiation of Emergency Protection Procedures.

12. Where medical and nursing staff conclude that there are no concerns identified, the request for discharge will be honoured and the parent / legal representative will be asked to sign the CTMA form. In these situations, hospital staff should consider whether a referral of the child to Social Services for assessment as a Child in Need is warranted.

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quote:

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Originally posted by justlooking:
...In this case the parent removed a very sick child without any discharge arrangements and the hospital would have been failing in its duty of care if it took no action.

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quote:

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According to Mr. King himself, the last thing he spoke with the hospital about with respect to treatment was taking Ashya off all cancer treatment. His subsequent actions that the hospital saw are entirely in line with the idea that he was doing this.

Do you believe that Mr. King should have been allowed to completely take Ashya off all cancer treatment? Just because he is the father?

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quote:

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Originally posted by L'organist:
Bottom line is one must seriously question the gumption of 'the authorities' if the result of your concerns - however much you may feel them to be justified - is that a small child ends up in a foreign hospital without Mum or Dad, denied visits from siblings, unable to speak and being cared for by staff unable to communicate with him.

Do tell me which part of that makes any kind of sense.

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quote:

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I think we can all see from this just how effective, caring, compassionate and intelligent a parent the state makes - but that is a better bet?

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quote:

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Originally posted by itsarumdo:

This is one of the obfuscations around this case - what is legal as opposed to what is "right". The legalities of relationship and responsibility may affect how some one is allowed to act (or expected to act), but they do not define right action.

You're not alone in using legal terms in an essentially moral argument, because the legal principles have deeply infiltrated societal ways of thinking about this.

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quote:

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Originally posted by North East Quine:
Originally posted by Justinian:

quote:

---

According to Mr. King himself, the last thing he spoke with the hospital about with respect to treatment was taking Ashya off all cancer treatment. His subsequent actions that the hospital saw are entirely in line with the idea that he was doing this.

Do you believe that Mr. King should have been allowed to completely take Ashya off all cancer treatment? Just because he is the father?

---

But this is where the massive breakdown in communication came about. Mr King stopped talking to the hospital because he feared being banned from his very sick son's bedside. He wasn't trying to take Ashya off all cancer treatment - the Prague hospital confirms that he was in contact with them, discussing radiotherapy in the form of Proton therapy. Indeed, he was trying to sell a property in order to pay for this treatment.

If Mr King hadn't been afraid of legal repercussions, he'd have been able to tell the hospital exactly what he hoped to do - and possibly Ashya could have been transferred straight from Southampton to Prague.

The big question to me is - how did a situation arise in which loving parents feared being banned from their child's hospital bedside because they were seeking alternative treatments? Had they misunderstood? Had someone at the hospital expressed themselves badly? How did this happen?

It seems to me that everything that happened thereafter flows from that.

---

quote:

---

Originally posted by itsarumdo:

quote:

---

Originally posted by justlooking:
...In this case the parent removed a very sick child without any discharge arrangements and the hospital would have been failing in its duty of care if it took no action.

---

As I said previously, "Duty of Care" is a legal term.

This is one of the obfuscations around this case - what is legal as opposed to what is "right". The legalities of relationship and responsibility may affect how some one is allowed to act (or expected to act), but they do not define right action.

You're not alone in using legal terms in an essentially moral argument, because the legal principles have deeply infiltrated societal ways of thinking about this.

---

quote:

---

In English tort law, an individual may owe a duty of care to another, to ensure that they do not suffer any unreasonable harm or loss. If such a duty is found to be breached, a legal liability is imposed upon the tortfeasor to compensate the victim for any losses they incur. The idea of individuals owing strangers a duty of care – where beforehand such duties were only found from contractual arrangements – developed at common law, throughout the 20th century.

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quote:

---

There are a number of distinct and recognisable situations in which the courts recognise the existence of a duty of care.

Examples include

one road-user to another
employer to employee
manufacturer to consumer
doctor to patient
solicitor to client
teacher to student

---

quote:

---

At this point he himself says he became uncommunicative.

---

quote:

---

Originally posted by Figbash:

quote:

---

Originally posted by orfeo:
Your argument is lacking in logic. How did the doctor/patient relationship arise in the first place? Did Ashya create it?

No. Children of that age have no capacity to enter into a doctor/patient relationship, and so they also lack the capacity to end it. Their parents make those decisions.

---

Your argument is lacking in reference to certain important facts. Southampton is a part of the United Kingdom, and not the United States of America.

It may be the case that US law recognises the parents of a child as the ultimate authority when it comes to making decisions on behalf of the child. UK law does not. In the UK it is acknowledged that parents do not always represent the best interests of their children and, when it is determined that such is that case, the state undertakes to represent the child's best interests.

In other words: in the US the child may be regarded as lying solely within the parents' dominion, and the rights of the parents to exercise said dominion are considered paramount, but in the UK the child is regarded as an individual, with rights which are considered more significant than those of the parents in those cases where the parents do not appear to have the child's best interests in mind. You may consider that illogical, but then, from a UK perspective the US position appears to be an abusers' charter.

Interestingly, this confusion is suffered also by Jehovah's Witnesses: their website explicitly states that parents do have absolute dominion over children, quoting the US Supreme Court as legal evidence to back this up. It does not seem to occur to them the the US Supreme Court does not hold sway outside of the US. As Jehovah's Witnesses emphasise the belief that parents do hold absolute sway, it is perhaps not surprising that they would, inevitably see the (child favouring) UK position as an affront to their sensibilities.

---

quote:

---

Originally posted by Matt Black:
Orfeo, if you really find yourself unable to sleep, knock yourself out on these; you're welcome!

---

Thankfully, I'm feeling tired.

But, you never know, if I feel the need for a bit of light reading in a break tomorrow from wrestling with my own horribly knotty legal problems (this week being knottier than usual)...
 

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Posted by itsarumdo (# 18174) on :
 

quote:

---

Originally posted by justlooking:
...

There are a number of distinct and recognisable situations in which the courts recognise the existence of a duty of care.
...

In this case the primary duty of the hospital is to the child who is its patient.

---

quote:

---

Originally posted by Figbash:
... dah de hah de dah...

Once we have concluded that the child's rights are pre-eminent, then we must consider whether the parents will always act in their best interest. The answer, obviously, must be no. Therefore mechanisms are required to deal with cases where the parents' desires are clearly not in accordance with the child's inalienable rights. Now, you may believe that when parents make demands about medical treatment, and discuss same in such a way as to make it clear that they have no real understanding of the subject and are, essentially, risking their child's health for the sake of a fantasy, that is in accord with the child's needs; I do not. And that judgement is all that is needed. Right and wrong do not (and should not) enter into it.

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quote:

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Originally posted by itsarumdo:
Although duty of care developed as common law, it is a direct genetic descendant of the health and safety at work act - see my post further up.

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quote:

---

Originally posted by orfeo:
My point was that the child lacks decision-making capacity, given the assertion that the child is the patient. I'm fairly sure that the UK doesn't allow children aged 5 to enter contracts or do anything else that requires legal capacity.

---

quote:

---

Originally posted by L'organist:

I can't help feeling that fairly near to the surface of the UK medics minds was the fact that the Kings are JWs: when you couple that with them not mutely following the course outlined for their son unquestioningly you can see how this dreadful situation arose.

---

quote:

---

Originally posted by BroJames:

quote:

---

Originally posted by itsarumdo:
Although duty of care developed as common law, it is a direct genetic descendant of the health and safety at work act - see my post further up.

---

This is an exact reversal of the actual historical reality.

The Health and safety at Work Act 1974 follows over 40 years after the basic establishment of the neighbour principle in Donoghue v Stevenson in 1932.

The general duty upon individuals to take reasonable care in their actions or omissions, so as not to cause harm to others proximate to them, was multiply established in case law before the Health and Safety at Work Act.

The Act is essentially a statutory formalisation of that pre-existing principle in the workplace setting, and makes its enforcement not merely a chance of which victims can afford to sue, but of the criminal law.

---

Thankyou, Bro - I can't quite understand why this specific issue stirs me up quite so much, though the theme of being powerless against authority I guess does ring a lot of bells

I wan't so much referring to the Act itself, as the absorption into popular culture of the principles, and the gradual expansion of the Act or its general gesture into almost every crevice of activity. We've been legalised. Which I guess might not seem so bad if you're a lawyer
 

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Posted by Zacchaeus (# 14454) on :
 
The hospital have said all along that the Kings were offered a second opinion, which they never took up
 

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Posted by Justinian (# 5357) on :
 

quote:

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Originally posted by L'organist:
The fact remains that at no time during Ashya's time in Southampton General show any signs of mistreating the boy. Sure, they questioned the medical staff and asked about possible treatments - but wouldn't you?

---

quote:

---

when all the information on the WWW is that PBT is ideal for the treatment of medulloblastoma.

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quote:

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And they questioned also starting him on chemotherapy because it is frequently the case that chemotherapy is given AFTER radiotherapy for the simple reason that chemo leaves a patient so debillitated that they aren't up to the rigours of radiotherapy.

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quote:

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As for the Kings being found 1000 miles away from the hospital in Prague, Mr King has stated from the beginning that they had gone to Spain to put property on the market, the sale of which will fund Ashya's treatment.

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quote:

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Originally posted by Justinian:

In short Mr. King added "Dealing with estate agents" to an already tight timescale. As well as adding "Disrupted the chaemotherapy the hospital in Prague thinks is necessary" to the tight timescale.

---

quote:

---

Originally posted by North East Quine:
Originally posted by orfeo:

quote:

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Does the local hospital my nephew was born in have an obligation to be certain my nephew is being looked after? Is there some sort of roving duty of care in relation to all children in the area?

---

Pretty much. The hospital check that, for example, if the parents are taking their newborn baby home by car, they are doing so in a properly fitted car seat. You can't just waltz out of hospital and put a baby in an unsecured carrycot on the back seat. Not here, anyway.

Once you're home, there are follow-up visits by a midwife, and then by a health visitor. Plus you're expected to show up regularly to have your baby weighed at a clinic. I'm not sure at what point alarm bells would start ringing if you kept your baby away from all health professionals, but it would happen at some point.

Also (voice of bitter experience) if your child hasn't been fully vaccinated (because your child had an adverse reaction to the first vaccination and your GP refused to give the second, and this is fully documented on your child's medical records) there are reassessments every few years of your child's not-fully-vaccinated status.

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quote:

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Originally posted by Gracie:
Also from further up the thread - I have listened a number of time to what Mr King has been saying and it was clear that the question was, what would happen if they refused any specific treatment (i.e. radiotherapy with devastating side effects) and most definitely not all treatment.

---

quote:

---

Originally posted by Gracie:

quote:

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Originally posted by Justinian:

In short Mr. King added "Dealing with estate agents" to an already tight timescale. As well as adding "Disrupted the chaemotherapy the hospital in Prague thinks is necessary" to the tight timescale.

---

Can you point to any evidence to prove that any assurance was given to Mr King before he left the hospital with his son that the chemotherapy was in preparation for the proton bean treatment or indeed that the hospital in Southampton had taken at all seriously his request for his son's medical inforamtin to be passed on to the centre in Prague?

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quote:

---

Also from further up the thread - I have listened a number of time to what Mr King has been saying and it was clear that the question was, what would happen if they refused any specific treatment (i.e. radiotherapy with devastating side effects) and most definitely not all treatment.

---

quote:

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Originally posted by JoannaP:

quote:

---

Originally posted by orfeo:
My point was that the child lacks decision-making capacity, given the assertion that the child is the patient. I'm fairly sure that the UK doesn't allow children aged 5 to enter contracts or do anything else that requires legal capacity.

---

Can you provide any evidence for the claim that to be a patient requires legal capacity rather than just to be in receipt of medical care?

What is the correct term used to designate a person in a coma in an Intensive Care Unit?

---

quote:

---

Originally posted by JoannaP:

quote:

---

Originally posted by orfeo:
My point was that the child lacks decision-making capacity, given the assertion that the child is the patient. I'm fairly sure that the UK doesn't allow children aged 5 to enter contracts or do anything else that requires legal capacity.

---

Can you provide any evidence for the claim that to be a patient requires legal capacity rather than just to be in receipt of medical care?

What is the correct term used to designate a person in a coma in an Intensive Care Unit?

---

quote:

---

Originally posted by JoannaP:

quote:

---

Originally posted by Gracie:
Also from further up the thread - I have listened a number of time to what Mr King has been saying and it was clear that the question was, what would happen if they refused any specific treatment (i.e. radiotherapy with devastating side effects) and most definitely not all treatment.

---

So why would the chief paediatrician lie? Do you believe that Mr King is also accurate when he says that the staff at Southampton hospital were going to kill Ashya or turn him into a vegetable?

A couple of people have suggested that the hospital staff were prejudiced against the Kings because they are Jehovah's Witnesses; I am wondering if the boot is on the other foot and the Kings were predisposed not to trust the hospital staff.

---

quote:

---

Originally posted by Justinian:

The chance of recovering the communication is, to me, answered by Mr King's statement that "So from that moment on I had to keep everything quiet."

---

quote:

---

Originally posted by orfeo:

You can claim all you like that only the actual patient has power over the doctor/patient relationship, but it's clearly not true because newborn infants do not choose their doctors.

---

quote:

---

Do you believe that Mr King is also accurate when he says that the staff at Southampton hospital were going to kill Ashya or turn him into a vegetable?

---

quote:

---

Originally posted by justlooking:

quote:

---

Originally posted by orfeo:

You can claim all you like that only the actual patient has power over the doctor/patient relationship, but it's clearly not true because newborn infants do not choose their doctors.

---

Has anybody claimed that?

As far as I can see the argument is that the doctor's duty of care is to the patient, however young that patient may be. Parents may choose a doctor for a child but they cannot control the doctor/patient relationship.

---

quote:

---

Originally posted by justlooking:
All the parent does is to initiate the doctor/patient relationship for the child. Parents are parties to the relationship but they are not the patient and the doctor's first duty is to the patient. Changing a GP doesn't alter anything - it would just move the relationship to a different doctor.

It's the same with a school. Parents can choose a school and the school then has a duty of care to the child. Parents do not control the teacher/pupil relationship.

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quote:

---

[If you think that a parent can take their child out of one school and put them in another school, you think the parent controls the teacher/pupil relationship.

---

quote:

---

Originally posted by justlooking:

quote:

---

[If you think that a parent can take their child out of one school and put them in another school, you think the parent controls the teacher/pupil relationship.

---

No I don't. Because the kind of relationship under discussion places a legal duty of care on the professional party. That duty of care is controlled by legislation, guidelines and professional practice, not by parents.

---

quote:

---

Originally posted by orfeo:
The difference between "I don't want my son to be treated" and "I don't want you to treat my son" is probably what's put this whole saga on the front page in the first place.

---

quote:

---

Originally posted by justlooking:
What put this saga on the front page was an attempt by a parent to end a doctor/patient relationship without regard to the doctor's duty of care.

---

quote:

---

Originally posted by orfeo:
Let me put the point another way, lest I get another round of people talking to me as if I'd said that it was fine if a child didn't get treated by anyone at all.

I'm talking about the relationship between a specific doctor and a specific patient. That's what a doctor/patient relationship is.

As North East Quine and Gracie have set out quite well, there may well have been a miscommunication between the parents and the hospital about whether the father meant "I don't want my son treated" or "I don't want my son treated HERE, BY YOU".

They are 2 different questions. I accept that the parents have an obligation to ensure that their son is treated. I've accepted that from the very beginning. I've said from the beginning that not getting your child any kind of treatment is a form of neglect.

What I've also been trying to point out, from very early on, is that it's the parents that decide which medical treatment is delivered from the range of options and who by.

---

quote:

---

Originally posted by orfeo:
I might as well also add, while I'm here munching on breakfast, how striking it's been that the argument 'against' the proton beam therapy never seems to have risen any higher than "it's more expensive and it won't improve his chances".

Fine. Are those reasons for him not to have it? No.

---

quote:

---

Originally posted by Justinian:
The problem is that the information Southampton Hospital had was almost entirely consistent with the normal behaviour of people who say "I don't want my child treated at all" and very much inconsistent with the normal behaviour of people who say "I don't want my child treated by you."

If Mr. King hadn't turned uncommunicative after the miscommunication, but had tried to work out what was going on this wouldn't have happened. If he had properly prepared in advance and had the patient discharged into the care of another medical professional none of this would have happened. If he hadn't disappeared his son none of this would have happened.

---

quote:

---

Originally posted by Justinian:

There is however one huge question. What happened to the letter Mr. King says he wrote Dr. Nicolin that said he was willing to pay for the treatment himself? (Once that specific combination arises then unless the hospital is e.g. homeopathic) If he received it and ignored it then he deserves a major disciplinary at the very least. And the entire fiasco follows from his malfeasance. If it was not received that too needs an investigation. I hope that Southampton are one of the trusts that scan all the letters they receive.

---

quote:

---

Originally posted by orfeo:
Absolutely agree that "you can't have this treatment on the NHS" is different. Relational statements again. Guard your prepositions, people.

---

quote:

---

Originally posted by justlooking:

quote:

---

Originally posted by orfeo:
Absolutely agree that "you can't have this treatment on the NHS" is different. Relational statements again. Guard your prepositions, people.

---

What kind of relationship do you think is implied by such a statement? i.e. what is the relationship between a service provider and a service user?

In the case under discussion there will be a network of relationships involving the NHS, the doctors, the patient and the patient's parents. There may be conflicting interests and wishes between any of them.

Discussion of the doctor/patient relationship figured strongly in the Michael Jackson case. It was clearly not that of employer and employee because the doctor had a duty of care which meant he had to act in his patient's best interests which may not be in accordance with his patient's wishes.

---

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by justlooking:

quote:

---

[If you think that a parent can take their child out of one school and put them in another school, you think the parent controls the teacher/pupil relationship.

---

No I don't. Because the kind of relationship under discussion places a legal duty of care on the professional party. That duty of care is controlled by legislation, guidelines and professional practice, not by parents.

---

The existence of the relationship. I thought it was perfectly clear we were talking about deciding to either start or end the relationship, not what goes on while the relationship is in place.

---

Yes, but there are some major safeguards around the way in which such a relationship can be terminated. Once a parent entrusts a child to an educational establishment, within the scope of the law the school is allowed to do things that the parent disagrees with.

My fiancé is a teacher in a rather rough middle school where there have been some major problems with the management. For the start of the new school year, a crack team has been sent in by the Rectorate to sort things out.

Punctuality has been a persistent problem in the school. Yesterday, as part of the new shock and awe tactics, the deputy head was on the front gate at 8:15 to meet the kids who turned up late (school starts at 8 o’clock). Once there was a decent crowd of latecomers, they were handed over to a school counsellor and herded off to a room, thus making them completely miss the lesson they had arrived late for. At this point, the heads called the parents and told them that their child had arrived late for school and would consequently be kept half an hour later at the end of the day.

When, as they expected, the parents kicked up a fuss and told the headteachers they had no right, the headteachers (who had a paper in front of them with the relevant legal texts on it) told them “according to article bla bla bla of the Civil code, you have entrusted the education of your child to the National Education. We are therefore responsible and are entitled to impose sanctions on your child if they don’t obey the internal rules of this school. If you don't want this to happen again, please ensure your child arrives on time in future.” There was nothing the parents could do. At the end of the day, the kids were indeed kept late and given a stern half-hour lecture by the new head. (They looked terrified. The teaching staff OTOH thought it was hilarious. )

The parents have absolutely no recourse under the law if the school imposes an appropriate sanction (being kept late) for not following the school’s internal procedures. They have handed over responsibility for that part of their child’s wellbeing (their education) to the school. If the parents don’t like it, they can make alternative arrangements for their children’s education. But they can’t decide that they’re not sending their child to school today because they don’t like the punishment the child got yesterday. They may not unilaterally end the relationship with the school by withdrawing their child until they can demonstrate that suitable alternative arrangements are in place.
 

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Posted by Alisdair (# 15837) on :
 
Something this case highlights, at least to me with the evidence so far available, is the paternalism that too often infuses the relationship between the 'medical profession' and 'ordinary people'.

It illustrates the reality that to a large extent we have allowed so called 'professionals' (medical/legal/...) to 'own' the area of life they apply their knowledge in, rather than acting as 'servants'. That 'ownership' can and does often extend to an ownership of those who are receiving that professional's service.

In other words, people become dis-empowered (horrible word), are stripped of personal/social responsibility and become 'children' under the guardianship of the professionals---who clearly know what's best because they have laid claim to authority in that area of life.

It is an insidious and corrosive progression. Instead of 'service' to others we have a tendency to 'control' of others, which at it's worst is heading towards de-humanisation---the treating of human beings as though they are merely objects, subject to the will of the one who claims authority over them.

The case in question seems to offer an example of what can happen when overweening authority feels thwarted and threatened and then completely fails to retain any sense of proportionality or balance in the relationship: 'Quick, our property has been stolen, our reputations are threatened. We must act decisively to recover both!'---completely forgetting that these are human beings, who are neither slaves nor prisoners, who are, on the face of what we know, people who have proven themselves over time to be entirely concerned for the well being of their child.

Just to finish, on a slightly transcendent note: we are all going to die, sooner or later, it is the natural way of things. In my experience, working in a hospital as I do, what matters most to most people is not so much whether they will be cured (although that is naturally often hoped for), but whether they will be 'looked after', i.e. cared for, treated with respect and compassion, even loved (if institutional care is capable of such a thing, which it is given wise and encouraging leadership and example).

This whole case went off the rails long before the family hit the road for Spain, and the failure that occurred back down the line was clearly not addressed properly, leading directly to the tragic farce that has been played out in the media.

Will the right lessons be learned, or will the implicit professional paternalism merely dig in with stubborn self-justifications?

[ 05. September 2014, 10:09: Message edited by: Alisdair ]
 

---

Posted by North East Quine (# 13049) on :
 

quote:

---

Originally posted by Karl: Liberal Backslider:
I've not seen a link to this on this thread: http://www.uhs.nhs.uk/aboutthetrust/newsandpublications/latestnews/2014/latest-statement-in-relation-to-ashya-king,-2-septemb er-2014.aspx

No particular dog in this fight, but thought this should be in there.

---

quote:

---

Originally posted by North East Quine:

quote:

---

Originally posted by Karl: Liberal Backslider:
I've not seen a link to this on this thread: http://www.uhs.nhs.uk/aboutthetrust/newsandpublications/latestnews/2014/latest-statement-in-relation-to-ashya-king,-2-septemb er-2014.aspx

No particular dog in this fight, but thought this should be in there.

---

Is there a misprint in that statement? Because when Ashya went missing, the hospital said that he'd had "extensive surgery" seven days earlier i.e. 21 August. But the statement says that the tumour was successfully removed on 24 July. There's no mention of the 21 August "extensive surgery" in that statement.

Plus, the statement says that for best results chemo / radiotherapy should start within 4-6 weeks of the original 24 July surgery. But the treatment hadn't started on 28 Aug, 5 weeks after the original surgery.

The biggest gulf appears to be between what the hospital understood Mr King to be saying, and what Mr King understood the hospital to be saying, but there also seems to be a gulf between what the hospital said then and what it's saying now. (I accept Data Protection might explain this.)

---

quote:

---

Originally posted by la vie en rouge:
The parents have absolutely no recourse under the law if the school imposes an appropriate sanction (being kept late) for not following the school’s internal procedures.

...

If the parents don’t like it, they can make alternative arrangements for their children’s education.

---

quote:

---

Originally posted by Zacchaeus:
Yes but the relationship has to be formaly with a new one in place first that is the point.

---

quote:

---

Originally posted by orfeo:
Saying that you can't have this treatment on the NHS is not the same as saying you can't have this treatment at all.

---

quote:

---

The relationship implied is that having treatment "on the NHS" means you are having a service that is NHS approved, and (as far as I understand) paid for by the NHS, and provided by people that the NHS considers qualified.

---

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by la vie en rouge:
The parents have absolutely no recourse under the law if the school imposes an appropriate sanction (being kept late) for not following the school’s internal procedures.

...

If the parents don’t like it, they can make alternative arrangements for their children’s education.

---

You've just set out the recourse.[...] You've just identified precisely the same recourse I've been talking about.

---

quote:

---

Originally posted by Clint Boggis:

quote:

---

Originally posted by orfeo:
Saying that you can't have this treatment on the NHS is not the same as saying you can't have this treatment at all.

---

This is true. Good.

quote:

---

The relationship implied is that having treatment "on the NHS" means you are having a service that is NHS approved, and (as far as I understand) paid for by the NHS, and provided by people that the NHS considers qualified.

---

Not so. You misunderstand a simple phrase.

If I say "have a drink on me" I don't mean have a drink I approve of at your own expense, I mean have a drink at my expense.
.

---

quote:

---

Originally posted by la vie en rouge:
The point is that there are a number of significant hoops that must be jumped through before the recourse becomes effective.

---

quote:

---

The parents cannot decide that they just aren't sending their children to school today or they will be in considerable trouble with the authorities.

---

quote:

---

In the same way, you can't just remove your child from a hospital.

---

quote:

---

If so requested, you need to be able to show that you have already made viable alternative arrangements, not just that you're planning to make them some time in the future.

---

quote:

---

Originally posted by North East Quine:

quote:

---

Originally posted by Karl: Liberal Backslider:
I've not seen a link to this on this thread: http://www.uhs.nhs.uk/aboutthetrust/newsandpublications/latestnews/2014/latest-statement-in-relation-to-ashya-king,-2-septemb er-2014.aspx

No particular dog in this fight, but thought this should be in there.

---

Is there a misprint in that statement? Because when Ashya went missing, the hospital said that he'd had "extensive surgery" seven days earlier i.e. 21 August. But the statement says that the tumour was successfully removed on 24 July. There's no mention of the 21 August "extensive surgery" in that statement.

Plus, the statement says that for best results chemo / radiotherapy should start within 4-6 weeks of the original 24 July surgery. But the treatment hadn't started on 28 Aug, 5 weeks after the original surgery.

The biggest gulf appears to be between what the hospital understood Mr King to be saying, and what Mr King understood the hospital to be saying, but there also seems to be a gulf between what the hospital said then and what it's saying now. (I accept Data Protection might explain this.)

---

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Clint Boggis:

quote:

---

Originally posted by orfeo:
Saying that you can't have this treatment on the NHS is not the same as saying you can't have this treatment at all.

---

This is true. Good.

quote:

---

The relationship implied is that having treatment "on the NHS" means you are having a service that is NHS approved, and (as far as I understand) paid for by the NHS, and provided by people that the NHS considers qualified.

---

Not so. You misunderstand a simple phrase.

If I say "have a drink on me" I don't mean have a drink I approve of at your own expense, I mean have a drink at my expense.
.

---

Are you seriously suggesting that the word "on" automatically has a single meaning, applicable to both a government-run nationalised health service and your wallet?

"Have a drink on me. The drink is on the table."

EDIT: And you haven't even read what I said. I said the expense was paid by the NHS!

---

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Zacchaeus:
Yes but the relationship has to be formaly with a new one in place first that is the point.

---

And it says that, where?

Are you proposing that when a family moves interstate, the school that the family is leaving has some power over the enrolled children until the family identifies the name of the school that the children will attend in their new location?

We've already established there is no obligation to have a child enrolled in a school at all. There is only an obligation to have a child EDUCATED.

There are millions of conceptual miles between the idea that the old school would like to have information about the new arrangements if they are known, and the notion you're proposing that the new relationship "has to be formally in place". The latter cannot possibly be true if home schooling is permitted.

---

quote:

---

I go to school at Sunnydale High...

---

 

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Posted by orfeo (# 13878) on :
 

quote:

---

Originally posted by Zacchaeus:

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Zacchaeus:
Yes but the relationship has to be formaly with a new one in place first that is the point.

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And it says that, where?

Are you proposing that when a family moves interstate, the school that the family is leaving has some power over the enrolled children until the family identifies the name of the school that the children will attend in their new location?

We've already established there is no obligation to have a child enrolled in a school at all. There is only an obligation to have a child EDUCATED.

There are millions of conceptual miles between the idea that the old school would like to have information about the new arrangements if they are known, and the notion you're proposing that the new relationship "has to be formally in place". The latter cannot possibly be true if home schooling is permitted.

---

Well I have no idea about interstate or what happens over the pond, as I live in England – and I am not proposing anything, I was reporting to you was what I read on a news website.
And that was that English schools were being told to follow up on unexpected non returners, so that the authorities were satisfied that they knew where the children were.

Even home schooling has to be ok’d with the authorities too, yes people have the right to home school but they have to be able to tell the education authorities that is what they are doing. Children are not supposed to just go off the radar and schools were having their knuckles rapped because it was happening too often.

You cannot just remove a child from school and never go back, without evidencing where and how the child is getting its education.
Or you can find yourself in court for your child’s non attendance

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quote:

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Originally posted by orfeo:
But that is what I said. I said, paid for by the NHS. Why are you continuing to disagree with me by agreeing with me?

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quote:

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Originally posted by orfeo:
The relationship implied is that having treatment "on the NHS" means you are having a service that is NHS approved, and (as far as I understand) paid for by the NHS, and provided by people that the NHS considers qualified.

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quote:

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The reason the treatment hadn't started 5 weeks later was that the parents wouldn't consent to it, isn't it?

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quote:

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Originally posted by justlooking:
orfeo, you began this thread by asking 'who knows best - the state or the parents?

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quote:

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What many of us have been trying to explain is that it isn't a simple either/or situation. The answer could be both and neither.

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quote:

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Nor is it primarily about power and control. It is about children's rights, their best interests and the responsibilities of both parents and state to act in accordance with those rights and best interests.

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quote:

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In the case we're talking about is a young child whose rights and interests are safeguarded by laws and procedures which are informed by, among other things, the UN Convention on the Rights of the Child

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quote:

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Ashya's parents and state institutions are obliged to comply with laws and procedures when decisions are being made about his medical treatment.

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quote:

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The way the parents removed him from hospital put the medical staff under a legal obligation to take immediate action. They had no discretion to choose to do nothing.

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quote:

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In such a situation power and control can be seen as ultimately with the child because his rights and best interests dictate what happens.

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In practical terms the court is now in control. The judge will decide, not on the basis of his or her personal views but on how best to secure the child's rights and provide medical treatment in accordance with his best interests. It may be that the court has appointed a Guardian ad Litum to represent Ashya's wishes because the judge must also try to determine what his wishes would be if Ashya was able to express them.

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quote:

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When it comes to education UK law requires parents to provide for this either by attendance at school or otherwise. If they choose a state school parents must ensure the child attends the school regularly. Failing to do this is an offence for which parents can be fined or even imprisoned.

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They can of course withdraw their child from any school by notifying the school or education authority and asking for the child's name to be removed from the register. In this case the education authority can make enquiries to satisfy themselves that the child is going to another school or is being home educated. The former school has no remit to make any enquiries about future education and if this is home education the local authority must proceed according to Department for Education guidelines - elective home education

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You are right in saying that parents continually make decisions for their children however some decisions may be open to enquiry, challenge and possibly control by statutory bodies acting to safeguard children.

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quote:

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Originally posted by Clint Boggis:

quote:

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Originally posted by orfeo:
But that is what I said. I said, paid for by the NHS. Why are you continuing to disagree with me by agreeing with me?

---

Because you're not right. You said:

quote:

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Originally posted by orfeo:
The relationship implied is that having treatment "on the NHS" means you are having a service that is NHS approved, and (as far as I understand) paid for by the NHS, and provided by people that the NHS considers qualified.

---

You talked about approval as being the determining factor, with costs being secondary. I said "on the NHS" means they're paying, with approval being implicit.

Approval of forms of medical treatment is the responsibility of a body called NICE which considers efficacy as well as cost. The NHS usually provides treatment but may arrange private treatment and cover the bill, in which cas it's still "on the NHS". It doesn't provide unapproved (by NICE) treatments which may be experimental or unduly costly compared with likely quality of life improvements.

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quote:

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Originally posted by Alisdair:

It illustrates the reality that to a large extent we have allowed so called 'professionals' (medical/legal/...) to 'own' the area of life they apply their knowledge in, rather than acting as 'servants'. That 'ownership' can and does often extend to an ownership of those who are receiving that professional's service.

In other words, people become dis-empowered (horrible word), are stripped of personal/social responsibility and become 'children' under the guardianship of the professionals---who clearly know what's best because they have laid claim to authority in that area of life.

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quote:

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Originally posted by Alisdair:

Just to finish, on a slightly transcendent note: we are all going to die, sooner or later, it is the natural way of things. In my experience, working in a hospital as I do, what matters most to most people is not so much whether they will be cured (although that is naturally often hoped for), but whether they will be 'looked after', i.e. cared for, treated with respect and compassion, even loved (if institutional care is capable of such a thing, which it is given wise and encouraging leadership and example).

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quote:

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Originally posted by orfeo:
[QUOTE]Originally posted by justlooking:
orfeo, you began this thread by asking 'who knows best - the state or the parents?

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quote:

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What many of us have been trying to explain is that it isn't a simple either/or situation. The answer could be both and neither.

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quote:

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Nor is it primarily about power and control. It is about children's rights, their best interests and the responsibilities of both parents and state to act in accordance with those rights and best interests.

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quote:

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The way the parents removed him from hospital put the medical staff under a legal obligation to take immediate action. They had no discretion to choose to do nothing.

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Ashya's parents have achieved a great deal of publicity and offers of funding but they have also delayed his continued treatment and caused considerable alarm.

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Originally posted by Karl: Liberal Backslider:
Is it worth pointing out that at the point that the search started and the IAW were issued, all that was known by the hospital and the police was that a seriously ill child had vanished from the hospital without explanation?

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quote:

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Originally posted by justlooking:
I have the impression from many of your posts you've been arguing that the parent is, or should be, in control.

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quote:

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Originally posted by Eutychus:


*I still can't get over this "without the consent of the hospital" terminology. Can somebody point to where that expression has grounds in law?

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If no agreement can be reached, lawyers for the parents and the NHS trust will appear before the judge on Monday and the court will make the final decision over the five-year-old’s treatment.

But today, Spanish local officials also insisted that if an agreement cannot be reached, Ashya's future will be determined by the doctors treating him in Malaga - and not the High Court.

Andalucia's regional Health Minister said medics looking after Ashya at the Hospital Materno-Infantil in Malaga would have 'the last word' under a 2005 regulations governing healthcare for minors in southern Spain.

They guarantee that the interests of the child should always prevail. Regional Health Minister Maria Jose Sanchez Rubio said: 'Whoever has the child's custody, the rights of that child are determined by the laws of the country the child is presently in. The child is here and so the rules here apply. 'Every decision about his future is adopted in conjunction with the local State Prosecution Service to guarantee that from a judicial and protection point of view, the interests of the child always prevail.'

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quote:

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Originally posted by justlooking:

quote:

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Originally posted by Eutychus:


*I still can't get over this "without the consent of the hospital" terminology. Can somebody point to where that expression has grounds in law?

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The Daily Mail has an updated article which refers to the legal situation in Spain:

Ashya King can't be moved from Malaga hospital without High Court permission

quote:

---

If no agreement can be reached, lawyers for the parents and the NHS trust will appear before the judge on Monday and the court will make the final decision over the five-year-old’s treatment.

But today, Spanish local officials also insisted that if an agreement cannot be reached, Ashya's future will be determined by the doctors treating him in Malaga - and not the High Court.

Andalucia's regional Health Minister said medics looking after Ashya at the Hospital Materno-Infantil in Malaga would have 'the last word' under a 2005 regulations governing healthcare for minors in southern Spain.

They guarantee that the interests of the child should always prevail. Regional Health Minister Maria Jose Sanchez Rubio said: 'Whoever has the child's custody, the rights of that child are determined by the laws of the country the child is presently in. The child is here and so the rules here apply. 'Every decision about his future is adopted in conjunction with the local State Prosecution Service to guarantee that from a judicial and protection point of view, the interests of the child always prevail.'

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quote:

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Originally posted by Zacchaeus:
Firstly, I was not asserting anything, but passing on a news item which I had read which was reporting on responsibilities of schools and local authorities, regarding children who disappear out of the school system.

But sorry to be unclear – state schools in England (I won’t answer for the other UK countries, as systems vary a bit) do not stand alone they are answerable to a local education authority (which is a part of the local government authority that deals will all local services) and then to the department of education.

It’s slightly complicated with the advent of academies and free schools (it would take somebody in the system at the moment to explain properly) but the end of the day the school is responsible to the authority up the chain. Who is answerable to the central government department of Education– these are what I meant by the authorities, shorthand for the higher up part of the chain that the school has to answer to. But basically a part of the same system.

You can of course report directly to the Local education department, about your child’s school movements (and in the case of home schooling you may have to) but most parents deal straight with their schools – and the school passes on the necessary information. But the education department will demand to know the details of your child’s schooling and what your intentions are and if they are not satisfied will take you to court.

I was, as I said, reporting something I had seen, I was not making any assertions myself. So if you don’t agree with what I said argue with the BBC. This was a news item saying that schools as the ones at the sharp end of the system the schools were to be vigilant and pass up the chain information about any unexpected non returning children.

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quote:

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Originally posted by orfeo:
the very fact that a court order was necessary to achieve that result rather suggests that the legal situation was different before the court order!

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quote:

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Originally posted by Eutychus:

quote:

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Originally posted by orfeo:
the very fact that a court order was necessary to achieve that result rather suggests that the legal situation was different before the court order!

---

It is precisely because the term consent (on the part of the hospital) has been used from the outset that I'm concerned. It illustrates a mindset that very possibly extends beyond the actual legal situation - if so, it tips the balance unlawfully in favour of the authorities.

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quote:

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Under section 46 of the Children Act 1989, where a police officer has reasonable cause to believe that a child would otherwise be likely to suffer significant harm, s/he may:

remove the child to suitable accommodation and keep him or her there; or
take reasonable steps to ensure that the child’s removal from any hospital, or other place in which the child is then being accommodated is prevented.

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quote:

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Originally posted by justlooking:
latest news

The court has decided Ashya can be taken to Prague for treatment. The wardship order will be removed when he is admitted to the Prague hospital.

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quote:

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Originally posted by orfeo:
You might also find it instructive to read all the conditions and qualifications on that page, and more importantly in the legislation that it links to. Starting with the clear statements about informing the parents, that the police officer doesn't gain parental responsibility, and indeed the general lack of powers of the hospital itself.

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quote:

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Originally posted by orfeo:

quote:

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Originally posted by justlooking:
latest news

The court has decided Ashya can be taken to Prague for treatment. The wardship order will be removed when he is admitted to the Prague hospital.

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What? But that's what the dangerous suspected criminals wanted!

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quote:

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Originally posted by orfeo:

quote:

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Originally posted by justlooking:
latest news

The court has decided Ashya can be taken to Prague for treatment. The wardship order will be removed when he is admitted to the Prague hospital.

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What? But that's what the dangerous suspected criminals wanted!

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quote:

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Originally posted by orfeo:
You might also find it instructive to read all the conditions and qualifications on that page, and more importantly in the legislation that it links to. Starting with the clear statements about informing the parents, that the police officer doesn't gain parental responsibility, and indeed the general lack of powers of the hospital itself.

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quote:

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In such circumstances, the police should inform the child (if he or she appears competent to understand) and take such steps as are reasonably practicable to ascertain the child’s wishes and feelings.

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quote:

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An emergency protection order gives authority to remove a child, and places the child under the protection of the applicant.

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43. If a constable removes a child under section 46 emergency powers, the child is deemed to be under police protection but neither the Designated Officer nor the Initiating Officer has parental responsibility for the child (see section 46(9)). However, the Designated Officer is responsible for doing what in all the circumstances of the case is reasonable to safeguard or promote the child's welfare, having regard in particular to the length of the period during which the child will be under police protection. In practical terms, this may mean just the provision of food and shelter etc. In an emergency medical situation, the doctor would act in the patient's best interest without express consent, as technically the officer would be unable to consent on the child's behalf. Other non-urgent areas that a person with parental responsibility has to decide upon (bearing in mind the limited time-span of police protection) fall outside the officer's responsibility.

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quote:

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Originally posted by justlooking:
Nothing on this page about informing parents.

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quote:

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(4)As soon as is reasonably practicable after taking a child into police protection, the constable concerned shall take such steps as are reasonably practicable to inform—

(a)the child’s parents;

(b)every person who is not a parent of his but who has parental responsibility for him; and

(c)any other person with whom the child was living immediately before being taken into police protection,

of the steps that he has taken under this section with respect to the child, the reasons for taking them and the further steps that may be taken with respect to him under this section.

...

(9)While a child is being kept in police protection—

(a)neither the constable concerned nor the designated officer shall have parental responsibility for him; but

(b)the designated officer shall do what is reasonable in all the circumstances of the case for the purpose of safeguarding or promoting the child’s welfare (having regard in particular to the length of the period during which the child will be so protected).

(10)Where a child has been taken into police protection, the designated officer shall allow—

(a)the child’s parents;

(b)any person who is not a parent of the child but who has parental responsibility for him;

(c)any person with whom the child was living immediately before he was taken into police protection;

(d)any person in whose favour a contact order is in force with respect to the child;

(e)any person who is allowed to have contact with the child by virtue of an order under section 34; and

(f)any person acting on behalf of any of those persons,

to have such contact (if any) with the child as, in the opinion of the designated officer, is both reasonable and in the child’s best interests.

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quote:

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Originally posted by orfeo:
I rather think that what it proves is that the parents weren't nuts for raising proton therapy as a treatment option in the first place. A few days ago the hospital was making public pronouncements about why there was no point to proton therapy.

Or have we forgotten that part?

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quote:

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Originally posted by orfeo:

quote:

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Originally posted by justlooking:
Nothing on this page about informing parents.

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I said read the Act. Did you read the Act, or are you still relying on a summary supplied by someone else?

"This page" is not the law of the land. "This page", though, HAS LINKS to the law of the land. Instead of quoting me a paraphrase of section 46, how about you actually read section 46?

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quote:

---

Originally posted by justlooking:

quote:

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Originally posted by orfeo:

quote:

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Originally posted by justlooking:
Nothing on this page about informing parents.

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I said read the Act. Did you read the Act, or are you still relying on a summary supplied by someone else?

"This page" is not the law of the land. "This page", though, HAS LINKS to the law of the land. Instead of quoting me a paraphrase of section 46, how about you actually read section 46?

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This is the Act - Section 46 from which the information from the police guidance notes is taken. You read it. It shows clearly that the law of the land aims to protect children, if it is necessary, from the actions of their parents.

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quote:

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Originally posted by cliffdweller:

quote:

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Originally posted by orfeo:
I rather think that what it proves is that the parents weren't nuts for raising proton therapy as a treatment option in the first place. A few days ago the hospital was making public pronouncements about why there was no point to proton therapy.

Or have we forgotten that part?

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No, haven't forgotten-- but it doesn't change my point, nor does it prove the point you appear to be trying to make.

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quote:

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Originally posted by orfeo:

quote:

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Originally posted by cliffdweller:

quote:

---

Originally posted by orfeo:
I rather think that what it proves is that the parents weren't nuts for raising proton therapy as a treatment option in the first place. A few days ago the hospital was making public pronouncements about why there was no point to proton therapy.

Or have we forgotten that part?

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No, haven't forgotten-- but it doesn't change my point, nor does it prove the point you appear to be trying to make.

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So, the parents WERE nuts for raising proton therapy as a treatment?

What does that make the judge for agreeing to it, over the Southampton doctors' continued objections?

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quote:

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Originally posted by orfeo:
Just criminally dangerous, then.

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quote:

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Originally posted by cliffdweller:

quote:

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Originally posted by orfeo:
Just criminally dangerous, then.

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I haven't seen anyone argue that either.

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quote:

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Current data do not provide sufficient evidence to recommend PBT in lung cancer, head and neck cancer, GI malignancies, and pediatric non-CNS malignancies.

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a systematic review of published peer-reviewed literature reported previously and updated here is devoid of any clinical data demonstrating benefit in terms of survival, tumor control, or toxicity in comparison with best conventional treatment for any of the tumors so far treated including skull base and ocular tumors, prostate cancer and childhood malignancies.

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quote:

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Originally posted by no prophet:
I suspect, heart rending as it is, that the conclusion to not provide this therapy would be considered to be reasonable in this case after sifting through about 7 or 8 of these reviews.

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quote:

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Originally posted by cliffdweller:
The basis for the arrest warrant was not what was known, but rather what was unknown. It seems to me that in this case the law as it's been described here operated exactly as it was supposed to-- put the brakes on when there was a reasonable cause for concern, took the brakes off once those fears were relieved.

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quote:

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Originally posted by orfeo:
You don't issues arrest warrants as a means of enforcing a civil order!! You issue arrest warrants for criminal offences.

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quote:

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Originally posted by justlooking:
The term 'consent' may be a way of referring to the usual process of discharge from hospital which requires medical staff to assess the patient's suitability for discharge and provide a 'discharge letter' which will be copied to the patient's GP. If doctors decide a patient is not fit for discharge but the patient insists on leaving then they are asked to sign a form to the effect that they are leaving against medical advice.

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quote:

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Originally posted by Doublethink:

quote:

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Originally posted by orfeo:
You don't issues arrest warrants as a means of enforcing a civil order!! You issue arrest warrants for criminal offences.

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This is not true in the UK in all cases. You may want to look at how the mental health act works - and how recall to hospital works in the case of a community treatment order.

(To be fair, we were surprised when we discovered that NHS staff were expected to apply for a warrant.)

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quote:

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Originally posted by orfeo:
Another article that resonates with me, because people have been citing various laws that are aimed at situations where parents are a threat to their child as if that makes any sense for a family that brought their sick child in for treatment and stayed at his bedside.

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quote:

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Originally posted by orfeo:

quote:

---

Originally posted by Doublethink:

quote:

---

Originally posted by orfeo:
You don't issues arrest warrants as a means of enforcing a civil order!! You issue arrest warrants for criminal offences.

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This is not true in the UK in all cases. You may want to look at how the mental health act works - and how recall to hospital works in the case of a community treatment order.

(To be fair, we were surprised when we discovered that NHS staff were expected to apply for a warrant.)

---

I'm looking at the Mental Health Act, and all that I can find about arresting people is in a part that is specifically about people involved in criminal proceedings.

If you are talking about powers to detain people, I fully accept that there are such powers in the Mental Health Act. But I cannot see anything that says these powers are exercised on an arrest warrant. Arrest warrants land you in jail not in hospital - in this case, a jail near Madrid.

Most of what I can find in that Act is about "an application for admission".

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quote:

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Originally posted by Doublethink:
Arrest is a risk management process used in the course of investigation (and certain civil situations) it is not either charge or conviction.

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quote:

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Originally posted by Doublethink:

quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Doublethink:

quote:

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Originally posted by orfeo:
You don't issues arrest warrants as a means of enforcing a civil order!! You issue arrest warrants for criminal offences.

---

This is not true in the UK in all cases. You may want to look at how the mental health act works - and how recall to hospital works in the case of a community treatment order.

(To be fair, we were surprised when we discovered that NHS staff were expected to apply for a warrant.)

---

I'm looking at the Mental Health Act, and all that I can find about arresting people is in a part that is specifically about people involved in criminal proceedings.

If you are talking about powers to detain people, I fully accept that there are such powers in the Mental Health Act. But I cannot see anything that says these powers are exercised on an arrest warrant. Arrest warrants land you in jail not in hospital - in this case, a jail near Madrid.

Most of what I can find in that Act is about "an application for admission".

---

Police can arrest you under section 136, to take you to a place of safety. "Sectioning" someone requires a warrant (AHPs have warrant cards). If you are recalled to hospital after the breach of the terms of a community treatment order, NHS staff have to apply for a warrant.

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quote:

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Originally posted by Doublethink:
Yes, a risk management process - in the same way remand is a risk management process.

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quote:

---

Originally posted by orfeo:

quote:

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Originally posted by Doublethink:
Arrest is a risk management process used in the course of investigation (and certain civil situations) it is not either charge or conviction.

---

You are going to have find for me something concrete that says it's permissible to say "you're under arrest" for anything other than a criminal investigation.

Risk management process? The right against unlawful imprisonment is one of the most fundamental rights in the entire system of English law (and hence most English-speaking countries). The Kings are suing for false imprisonment. I wouldn't dismiss their chances of success.

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quote:

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Whilst Section 136 does not use the term arrest, it is a preserved power of arrest under PACE and reasonable force may be used. Section 28 PACE requires an arrested person to be told that they are under arrest and the grounds for the arrest. Whilst a person detained under Section 136 is entitled to know that their liberty is being temporarily restricted, formally telling them that they are ‘under arrest’ may be counter-productive.

Therefore, the word arrest should be avoided, and instead the police officer should use tact and discretion in communicating to the person that they will have to come with police because of the officer’s concern for their well being, and that they have no choice in the matter. There is no requirement to caution a person detained under s.136 and this should not be done.

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quote:

---

Originally posted by Eutychus:

quote:

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Originally posted by Doublethink:
Yes, a risk management process - in the same way remand is a risk management process.

---

Oh wow. I'll have to take you on a visit round my jail some time and let you listen to some of the stories of people in there, awaiting trial (and thus presumed innocent), sometimes for years, and let you try that piece of semantics (Newspeak?) on them.

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quote:

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Originally posted by Doublethink:
Police can arrest you under section 136, to take you to a place of safety. "Sectioning" someone requires a warrant (AHPs have warrant cards). If you are recalled to hospital after the breach of the terms of a community treatment order, NHS staff have to apply for a warrant.

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quote:

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Originally posted by orfeo:
Exactly.

Now, contrast that to having your name splashed across the media as being subject to an arrest warrant. And being taken to jail.

You might also take note of where a person detained under the Mental Health Act is required to be taken. I'll give you a clue: it's not a high-security prison, which is what happened to the Kings.

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quote:

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Originally posted by Gracie:

quote:

---

Originally posted by Doublethink:
Police can arrest you under section 136, to take you to a place of safety. "Sectioning" someone requires a warrant (AHPs have warrant cards). If you are recalled to hospital after the breach of the terms of a community treatment order, NHS staff have to apply for a warrant.

---

Section 136 does not provide for arrest warrants. What it provides for are warrants to search for and remove patients. There is a huge difference.

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quote:

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Originally posted by Doublethink:
You seem to be confusing the arrest, with remand. The latter was a court decision made afterwards - I have no idea why a Spanish court chose to put them in a high security prison. That is in no way inherent in an arrest warrant.

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quote:

---

Originally posted by Doublethink:

You seem to be confusing the arrest, with remand. The latter was a court decision made afterwards - I have no idea why a Spanish court chose to put them in a high security prison. That is in no way inherent in an arrest warrant.

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quote:

---

Originally posted by Gracie:

quote:

---

Originally posted by Doublethink:
Police can arrest you under section 136, to take you to a place of safety. "Sectioning" someone requires a warrant (AHPs have warrant cards). If you are recalled to hospital after the breach of the terms of a community treatment order, NHS staff have to apply for a warrant.

---

Section 136 does not provide for arrest warrants. What it provides for are warrants to search for and remove patients. There is a huge difference.

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quote:

---

Originally posted by Gracie:

quote:

---

Originally posted by Doublethink:

You seem to be confusing the arrest, with remand. The latter was a court decision made afterwards - I have no idea why a Spanish court chose to put them in a high security prison. That is in no way inherent in an arrest warrant.

---

If the police in a given country arrest someone on the basis of an arrest warrant at the request of another state, the only place they can hold them is in a prison following a pretty short and highly regulated period in police remand. The Spanish police basically had no other option.

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quote:

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Originally posted by Doublethink:
Well what do you think remand is for then ? How is it legally justified ?

Risk of violence or reoffence and risk of flight basically. That doesn't mean those decisions are always right.

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quote:

---

Originally posted by orfeo:

quote:

---

Originally posted by Doublethink:
You seem to be confusing the arrest, with remand. The latter was a court decision made afterwards - I have no idea why a Spanish court chose to put them in a high security prison. That is in no way inherent in an arrest warrant.

---

Where would you take an arrested person, then?

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quote:

---

Originally posted by Eutychus:

quote:

---

Originally posted by Doublethink:
Well what do you think remand is for then ? How is it legally justified ?

Risk of violence or reoffence and risk of flight basically. That doesn't mean those decisions are always right.

---

Of course remand is part of a risk assessment process. But in my view, using the term here conceals and depersonalises what actually happens, completely unnecessarily.

How long before people are "detained as part of a risk assessment plan" because the state thinks they are being irresponsible in some way?

And by the way, no arrest could be performed in this case until there was a warrant issued by the CPS on the basis of a criminal charge, in this case child neglect.

I pretty much agree with that latest Guardian article linked to. I think the hospital vastly misrepresented the danger, convinced the police that massive action was required, the police rushed to the CPS who feverishly thumbed through the law book looking for the nearest charge that might possibly stick to have an excuse to issue the EAW. Which they originally justified as being "a way to talk to the parents".

It was an extremely blunt instrument and terms of how the family might have reacted (in view of how the hospital depicted them), perhaps not the best outcome of a risk assessment. I had visions of a mass suicide on the part of the hunted family as a result of the disproportionate response until I saw the first video from them.

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quote:

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Originally posted by Doublethink:
Did you read the met guidance ? It is an arrest under the Police And Criminal Evidence Act.

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Originally posted by Doublethink:
The court could have bailed them to a hotel in Malaga if it wished to do so.

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Advice: do not get arrested in continental Europe in a country with an inquisitorial system of justice if you are not a citizen of the country in question. Your first port of call, in all probability, is going to be jail. Possibly for a long time pre-trial.
 

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Posted by Gracie (# 3870) on :
 

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Originally posted by Doublethink:
If they felt at the hearing that they were not a flight risk they could have bailed them to a specific address, and they certainly weren't required to put them in a high security facility.

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Originally posted by Doublethink:
Do you not think the choking hazard was an acute risk ?

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Originally posted by Doublethink:
Also, people the police think might be patients. Like arrest generally, it is not the same thing as having established is

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Originally posted by Eutychus:

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Originally posted by Doublethink:
Do you not think the choking hazard was an acute risk ?

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Possibly. But I'm sure that if the child had choked in the hospital and medical staff had failed to save it, they would be throwing their hands up in horror at the idea that they might face criminal charges (well, no, they'd be putting out bland press releases).
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Originally posted by Gracie:

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Originally posted by Doublethink:
Also, people the police think might be patients. Like arrest generally, it is not the same thing as having established is

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Yes of course - but the point is patients or potential patients not offenders or potential offenders.

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Originally posted by Doublethink:
]The court could have bailed them to a hotel in Malaga if it wished to do so. As they had a police guard for Aysha at the hospital, I am unclear why they didn't - in the circumstances the one thing you could be reasonably certain of, was that there parents were not going to leave without their son.

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Originally posted by Eutychus:

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Originally posted by Doublethink:
The court could have bailed them to a hotel in Malaga if it wished to do so.

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Advice: do not get arrested in continental Europe in a country with an inquisitorial system of justice if you are not a citizen of the country in question. Your first port of call, in all probability, is going to be jail. Possibly for a long time pre-trial.

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Originally posted by Doublethink:
Legally, it is an arrest.

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Originally posted by Doublethink:
The reason I raised this in the first place was to point out the police use arrest for none offenders.

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Originally posted by Doublethink:
According to this, they could have chosen to bail.

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Originally posted by Gracie:

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Originally posted by Doublethink:
According to this, they could have chosen to bail.

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Of course there would be a hearing, if the individuals requested bail. The likelihood of this being granted for reasons already explained is minimal.

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Originally posted by Doublethink:
In other words, it was a choice the court made, that was not inherent in the issuing an arrest warrant. These were exceptional circumstances, they could have done something exceptional - they chose not to.

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Originally posted by Doublethink:
*bangs head against wall*

I was trying to demonstrate to orfeo that arrest is used in civil matters in the UK, sometimes.

PACE is a law, it interacts with other laws.

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Originally posted by Gracie:

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Originally posted by Doublethink:
If they felt at the hearing that they were not a flight risk they could have bailed them to a specific address, and they certainly weren't required to put them in a high security facility.

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Again bail is something that is granted to people who have been charged with an offence.

On that specific point, if Spain is anything like France, bail would have been pretty much an absolute impossibility. They would have had to have proved existing residence at a local address. A hotel or similar accommodation would not be accepted for these purposes.

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Originally posted by Doublethink:
IRRC don't they already have a residence in Spain ? They were intending to sell it.

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Originally posted by Gracie:

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Originally posted by Doublethink:
IRRC don't they already have a residence in Spain ? They were intending to sell it.

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They have a residence in Malaga, not in Madrid.

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Originally posted by Doublethink:
Don't know about Spain, but in the uk you can be released on bail, without a specific requirement to live in any given place, just report into a specific police desk at specific intervals.

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My knowledge is of the French criminal justice system not the Spanish one, but I would imagine they are similar.

In France, while in theory a relase on bail is possible, this will decrease to approximately zero if you are a foreign national even if you are a long-term resident in France, because the judge will deem you a flight risk by virtue of your nationality. I spend not inconsiderable amounts of time explaining this to confused and shell-shocked foreign inmates on remand at the prison I'm chaplain at.

As I say, try not to get arrested, still less charged over here.
 

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Posted by Doublethink (# 1984) on :
 
Yeah, I imagine you are less of flight risk if your seriously ill child is under police guard in a local hospital though.

Returning to the point that placing the parents in a maximum security prison for days was not an inherent consequence of seeking to arrest them. That was choice made in Spain by the local judge.

[ 06. September 2014, 13:34: Message edited by: Doublethink ]
 

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Posted by itsarumdo (# 18174) on :
 
Maybe they take the European Arrest Warrant seriously - assuming that it won't be issued by police in any other country unless the situation is very serious?
 

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Posted by Doublethink (# 1984) on :
 
Yes, but, they (the Spanish authorities) had the child under guard in a hospital - that changes the flight risk - you don't need a degree in human psychology to work that out. The judge did not need to make some massive leap of imagination.

They could no longer be actively neglecting the child if they didn't have custody, they couldn't take the child and leave if the child was guarded, and if it was believed that they acted - however misguidedly - out of a desperate desire to help their child and be with him - they were unlikely to bugger off leaving him in Malaga.

[ 06. September 2014, 14:07: Message edited by: Doublethink ]
 

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Posted by cliffdweller (# 13338) on :
 

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Originally posted by Doublethink:
]If they felt at the hearing that they were not a flight risk they could have bailed them to a specific address, and they certainly weren't required to put them in a high security facility.

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Originally posted by Doublethink:
Not really, see my post above.

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Originally posted by Doublethink:
Yeah, I imagine you are less of flight risk if your seriously ill child is under police guard in a local hospital though.

Returning to the point that placing the parents in a maximum security prison for days was not an inherent consequence of seeking to arrest them. That was choice made in Spain by the local judge.

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Originally posted by Doublethink:
PACE defines what arrest is.

I am not sure there is any value in pursuing this tangent any further.

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26 Repeal of statutory powers of arrest without warrant or order.

(1)Subject to subsection (2) below, so much of any Act (including a local Act) passed before this Act as enables a constable—
(a)to arrest a person for an offence without a warrant; or
(b)to arrest a person otherwise than for an offence without a warrant or an order of a court,shall cease to have effect.
(2)Nothing in subsection (1) above affects the enactments specified in Schedule 2 to this Act. [The schedule is headed 'Preserved Powers of Arrest', although not all the powers preserved are powers to arrest per se]

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1.10 Subject to paragraph 1.12, this Code applies to people in custody at police stations in England and Wales, whether or not they have been arrested, and to those removed to a police station as a place of safety under the Mental Health Act 1983, sections 135 and 136, as a last resort (see paragraph 3.16).

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Originally posted by orfeo:
Sorry, but I don't see how it's possible to say the proton therapy doesn't meet a standard of reasonable care. The highest the argument of Southampton doctors has ever been is "it'll cost more, and it won't be any better".

If it's not their money, then the cost is no longer their business. If it's not any better, then it's just as good as their idea.

If they actually had any basis for saying that it would be worse then I'm sure they would have said so. We've now even had a court hearing with a judge allowing the proton therapy treatment. No-one, anywhere, has popped up to say that it's a quack treatment.

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Originally posted by itsarumdo:
But the MHA doesn't affect anyone who is only receiving treatment for physical conditions?

If we are all under the powers of the MHA as soon as we enter hospital of treatment, heaven help us.

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Originally posted by BroJames:

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Originally posted by Doublethink:
PACE defines what arrest is.

I am not sure there is any value in pursuing this tangent any further.

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More accurately, removal to a place of safety under s136 of the MHA is not one of the powers abolished by the Police and Criminal Evidence Act 1984. Section 26 states:

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26 Repeal of statutory powers of arrest without warrant or order.

(1)Subject to subsection (2) below, so much of any Act (including a local Act) passed before this Act as enables a constable—
(a)to arrest a person for an offence without a warrant; or
(b)to arrest a person otherwise than for an offence without a warrant or an order of a court,shall cease to have effect.
(2)Nothing in subsection (1) above affects the enactments specified in Schedule 2 to this Act. [The schedule is headed 'Preserved Powers of Arrest', although not all the powers preserved are powers to arrest per se]

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It's rather over interpreting it to say that PACE defines that removal as an arrest. Code of practice C (PDF) to PACE distinguishes between criminal arrest and mental health detention thus:

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1.10 Subject to paragraph 1.12, this Code applies to people in custody at police stations in England and Wales, whether or not they have been arrested, and to those removed to a police station as a place of safety under the Mental Health Act 1983, sections 135 and 136, as a last resort (see paragraph 3.16).

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any additional information held by local police that’s reasonably considered relevant to the workforce being applied for

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power, under section 136 of the Act, is technically a form of arrest

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Originally posted by orfeo:
Sorry, but I don't see how it's possible to say the proton therapy doesn't meet a standard of reasonable care. The highest the argument of Southampton doctors has ever been is "it'll cost more, and it won't be any better".

If it's not their money, then the cost is no longer their business. If it's not any better, then it's just as good as their idea.

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Originally posted by North East Quine:
I thought a public appeal had raised enough money to pay for most of the treatment, with a private donor meeting the balance?

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I'm talking about what the parents have heard and understood.

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Originally posted by Jane R:
I think you are probably right, but as Doublethink has pointed out Asha will probably have special needs anyway.

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