Court rules that child should have cataract surgery

Family|February 7th 2017

When I first saw the judgment in Re EQ I thought it was just another one of those ‘parent having a religious objection to medical treatment for their child’ cases. I’ve seen many such cases over the years, the most common scenario being that the child needs a blood transfusion, and that this is not allowed by the parents’ religion. For a recent example of such a case see this post.

But Re EQ was different. It concerned a little girl, ‘EQ’, who was born on the 13th of September last. Unfortunately, shortly after she was discharged from hospital it was noticed that she was developing cataracts in both of her eyes. That diagnosis was confirmed by Moorfields Eye Hospital.

The medical experts recommended that EQ should undergo surgery under general anaesthetic to treat the cataracts. EQ’s mother opposed this treatment, and the NHS Trust applied to the court to decide the matter.

Why did EQ’s mother oppose the treatment? Well, it had nothing to do with religion. She was born with the same condition as EQ. She was operated on when she was five days old, but unfortunately developed glaucoma and other complications, as a result of which she lost her sight. She said in her statement:

“My mum was told that I should have surgery immediately and she was given a number of statistics advising that the earlier surgery was carried out the better. She went along with this and I had the operation at around one week old. I developed a number of the conditions that EQ is at risk of developing and I am therefore in a strong position to understand not only the conditions themselves, but the effect that these are likely to have on EQ’s life, freedom and independence.”

She also said:

“Because I do not have the protection of a lens on my eyes, I cannot go outside in cold or windy weather. If I get an eyelash or debris in my eye, I cannot get it out and have to wait for it to come out naturally. It can take around three days for an eyelash to come out of my eye and I can describe that pain as being as painful as labour. I do not want my daughter to go through this.”

As Mr Justice Francis, who heard the case, said, these were powerful statements. The mother also said that she had no doubt that EQ could lead a free and independent life without the risk of surgery, although tellingly she did indicate that she would probably agree to the surgery if it could be guaranteed that there would be no complications.

Mr Justice Francis had to decide what was in EQ’s best interests. The medical evidence indicated the following:

  1. That the mother had been exceptionally unlucky in the complications she had had following surgery, such problems being exceptionally rare.
  2. The mother was concerned that EQ’s eyes would not be protected if the lenses were removed, but the medical evidence was that the lack of protection would only be temporary, until the stiches inserted after the surgery had healed.
  3. If the surgery was not carried out immediately then there was a high probability that the surgery would not be a success. Accordingly, Mr Justice Francis was not prepared to accede to the mother’s request to adjourn the case so that EQ could undergo further tests.
  4. Statistics indicated that if the surgery was carried out immediately there was a 66 per cent chance of achieving an outcome of half of normal vision by the age of six years, although there was also a 10 per cent chance of EQ developing glaucoma and a 70 per cent chance of strabismus (i.e. a squint) by the age of six years.

As Mr Justice Francis explained, EQ’s welfare was of course the paramount consideration of the court. He concluded:

“Having considered the matter carefully … I have come to the very clear conclusion that it is in EQ’s best interests to have this surgery. I know that this will come as a blow to the mother. I find that the mother is unable to exercise objectivity (and I do not say that as a criticism of her) because of her life experiences because of the difficulties that she has had all of her life with her own eyes. It is clear to me from what I have heard that medical science has developed a very long time in the two decades or so since the mother had her own surgery … We must now all hope that medical science has advanced to a stage and that the opinions of the doctors are right and that great benefits can be achieved for EQ in having this surgery. I am not in any doubt at all that this is a benefit that there is a far greater chance here of reward and benefit to EQ than there is risk.”

Accordingly, the surgery would go ahead. It would have been carried out in December, just after the judgment was handed down. Let us hope it was a success.

You can read the full report of Re EQ here.

Image by Steve Snodgrass via Flickr under a Creative Commons licence

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