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A dying child and the state’s cruel indifference to her parents’ wishes


A TWO-YEAR-OLD girl, Alta Fixsler, died in hospital this month. Her life support was turned off by Manchester University NHS Foundation Trust against the wishes of her parents, and despite offers from hospitals in the US and Israel to fund her transfer to them for care.

Her father, Avraham, told the BBC: ‘She was our whole world . . .  I don’t know how to explain how I am feeling. She fought for her life for three hours after the life support was turned off.’

Alta had suffered a ‘catastrophic’ brain injury at birth and spent her life in the Royal Manchester Children’s Hospital. She required a feeding tube and a ventilator. Her parents went to court after the trust decided it was in ‘her best interest to remove life support and allow her to die’. 

Doctors said she was in ‘constant pain’ and had no ‘conscious awareness’. Her parents disagreed, but the trust applied to the much-criticised and highly secretive Family Division for ‘orders authorising the withdrawal of life-sustaining treatment’.

The court ruled on May 28 that further medical assistance was not in Alta’s ‘best interests’. In a cruel judgment it also rejected pleadings from her parents, members of Manchester’s ultra-Orthodox Hasidic community Belzer Chassidim, to let them take her to Israel. 

The parents’ claim that as Israeli citizens they had a right to transfer Alta to an Israeli hospital was denied, their religious belief that withdrawal of life support is always wrong was ignored, and their hopes to live in Israel with Alta until her death were frustrated. It is difficult to rationalise the legal decision.  

Mr Justice Alistair MacDonald declared that Alta’s treatment, including mechanical ventilation, should be discontinued and that she should be moved to a ‘palliative care pathway’. He ordered that doctors should ‘be at liberty to treat her in accordance with their clinical discretion’.  

The parents appealed, saying that they had shared Alta’s medical files with four doctors in the US who all concluded that she was in no pain.

Israel’s then-President, Reuven Rivlin, made a direct plea to Prince Charles asking him to intervene as ‘a matter of grave and urgent humanitarian importance’. He wrote: ‘It is the fervent wish of her parents, who are devoutly religious Jews and Israeli citizens, that their daughter be brought to Israel. Their religious beliefs directly oppose ceasing medical treatment . . .  and we have made arrangements for her safe transfer and continued treatment in Israel.’

US Senate majority leader Chuck Schumer, a Democrat, and the first Jewish leader of either chamber of Congress, wrote to the UK’s Ambassador, Karen Pierce, to request that all health decisions regarding Alta be suspended, and that she be permitted to travel to America with her father, who also has US citizenship. He also raised Alta’s case in a meeting with Boris Johnson – to no avail.

In his original ruling, Mr Justice MacDonald said that a transfer to Israel would ‘expose Alta to further pain and discomfort during the course of transfer for no medical benefit in circumstances where all parties accept that the treatment options now available for Alta provide no prospect of recovery’. The views of US and Israeli clinicians and Alta’s parents were ignored. 

In August, the Appeal Court rejected the parents’ appeal, upholding the lower court’s decision . So too did the European Court of Human Rights (ECHR)  who agreed with ‘expert decisions’ to end Alta’s life. 

In a well-considered and compassionate Times piece, Dominic Lawson expressed his disappointment, writing: ‘Our courts are wrong. Let this little girl leave.’

The Guardian reported that following the legal outcome the family felt uncomfortable even spending time with Alta in the hospital. Her father said, ‘You feel like they’re going against your wishes . . .  you’re feeling like a fool when you’re visiting.’

He appealed to the NHS to allow his daughter at least to die at home with her family. ‘Alta should be in our house for the last moments of her life,’ he told BBC Radio 4’s Today programme. ‘Give us our last wishes, to be with our child in our comfort zone, in our house.’ 

Consistent with their treatment of Mr and Mrs Fixsler, the authorities refused and Alta died in hospital, albeit in the arms of her parents. 

Chuck Schumer recently told Hamodia that he condemns the British action, saying: ‘I extend my prayers and support for the Fixsler family during this very difficult time. May Alta’s memory be a blessing. I continue to believe the policy followed here was wrong on many levels and regret that our multiple, and legally and morally well-grounded, pleas were unheeded by the British authorities.’

Alta’s body now rests in a graveyard outside Jerusalem after a funeral ceremony in Manchester.

Kathryn Lopez, a columnist,quotes Pope John Paul II, who wrote in 1995: ‘There exists in contemporary culture a certain Promethean attitude which leads people to think that they can control life and death by taking the decisions about them into their own hands. What really happens is that the individual is overcome and crushed by a death deprived of any prospect of meaning or hope.’ 

In the end, the British government, the medical establishment, the judiciary and hospital all got their way. The powerful prevailed over the weak and humanity lost. 

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Kate Dunlop
Kate Dunlop
Kate Dunlop is a mediator.

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