Update April 23, 2018: World watches as Alfie Evans’ life hangs in the balance – live updates here
LIVERPOOL, England, April 22, 2018 (LifeSiteNews) — Alfie Evans will be given Midazolam and Fentanyl when his life-support is removed.
Thomas Evans published part of a legal document today that explains how the Alder Hey Children’s NHS Foundation Trust plans to end his son’s life.
LifeSiteNews reported on Friday that Alfie’s life-support is scheduled to be removed on Monday, April 23. That information is under a publication ban in England.
The document Evans published states: “With regard to the process of withdrawal of ventilation from Alfie, the Trust proposes that … a cannula will be placed in situ and infusions of Midazolam (an anxiolytic) and Fentanyl (an analgaesic) will be prepared. They would be commenced and increased to control symptoms if necessary.”
The Trust would provide “suction of the mouth and an airway” to the infant while his heart and breathing monitors are stopped. His parents would be allowed to hold him, or he could be left in his cot, if they preferred. His breathing tube would then be disconnected from the ventilator and removed from his body. The medical team would then “step back “ and observe “Alfie’s situation and level of comfort,” so as to “respond quickly–ensuring comfort and support.”
The next paragraph of the document assumes the child will die as a result of the above actions.
“Once all external signs of life have ceased, one of the senior doctors will sensitively physically examine Alfie to confirm that death has occurred and report the time of death.”
One of the more dangerous side effects of Fentanyl, one of the drugs to be introduced to Alfie before his ventilator is removed, is respiratory depression. This could mean that there is a risk Alfie would be unable to breathe on his own because of the drug.
One argument of Alder Hey's supporters is that Alfie's life support is not “natural”. Their assumption is that Alfie will die “naturally” once he is removed from the ventilator. However, Alfie's father has long maintained that Alfie would be able breathe for himself were he not on sedatives preventing him from breathing independently.
Tom Evans posted the end-of-life plan to Facebook alongside recent photos of the boy, commenting “And this is the execution plan put in place by [Alder Hey]. Where is this treatment, where’s our involvement, where’s our say, how is this legal?”
According the the document, the withdrawal of Alfie’s ventilator–and the intravenous introduction of Midazolam and Fentanyl–will take place in Alfie’s cubicle in the Paediatric Intensive Care Unit at Alder Hey.
“It is the most private cubicle on the PICU and the Trust will aim to screen the area off and, if possible, ensure that any empty beds at the time are those most adjacent to Alfie’s cubicle,” it reads.
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Alder Hey requested that only four people from the family be present when Alfie’s “extubation” takes place: his parents and two immediate family members. They say that a “priest may be present at any time” if the family is being supported by one.
U.S. Pediatrics professor: “legalized killing” such as done to pet dog
Pediatrics professor Dr. Paul A. Byrne told LifeSiteNews that Alfie ought to have a tracheostomy.
“It is highly unlikely that Alfie will be able to breathe sufficiently without a tracheostomy, which was indicated and should have been done more than a year ago,” he said.
“A tracheostomy would facilitate treatment of Alfie, weaning from the ventilator, and allowing for transfer to another treatment center or his home,” Byrne continued.
“Not doing a tracheostomy has institutionalized Alfie. It has been somewhat like being in jail. Stopping [the] ventilator with ET tube in place is more difficult for Alfie; however, doctors will be able to say they simply stopped the ventilator.”
Byrne also said that the Midazolam and Fentanyl will shorten Alfie’s life.
“Midazolam (Versed) decreases memory,” he said. “Fentanyl decreases cough and breathing. These will shorten Alfie’s life so that those around will have a shorter time to watch and observe Alfie live.”
The American doctor did not mince words when giving his opinion of Alder Hey’s end-of-life plan.
“Not to treat Alfie with trach and ventilator is legalized killing,” he told LifeSiteNews. “A disease that is of unknown cause, and does not have a presently known treatment that has resulted in a child with disabilities is not a reason to euthanize, as is commonly [done] to a pet dog.”
Last minute petition filed to European Court of Human Rights
Tom Evans and Alfie’s mother, Kate James, have been trying to overturn a court order directing Alder Hey Children’s hospital in Liverpool to remove their son’s ventilator.
They filed a petition to the European Court of Human Rights after the UK Supreme Court refused to hear their case. They sought to overturn the UK Court of Appeal’s ruling last Monday against the parents’ argument that their son is being unlawfully detained by the hospital. It was the Court of Appeal that set Monday, April 23rd, as the date for the removal of Alfie's ventilation.
Alfie Evans, born May 9, 2016, is lying critically ill in Alder Hey Children’s NHS Foundation in Liverpool. His doctors say that he has an undiagnosed neurological condition that has resulted in serious and irreparable brain damage. In February 2018, Alder Hey won a legal decision that continued life support was not in the child’s best interests. Alfie’s parents have been fighting it ever since.
Last Tuesday, Tom Evans flew to Rome to meet with Pope Francis. The pontiff was said to be moved by the meeting with Evans and said that the young man’s courage reminded him of the love of God, Who is reluctant to lose any of His children.
At Pope Francis’ behest, Bishop Cavina is serving as the mediator between the Holy See and Alfie’s family. Barring a last-minute reprieve from the European Court of Human Rights, Cavina’s skills as a diplomat may be the family’s last hope to save Alfie’s life.
See copies of parts of the legal document below: