Alfie Evans died yesterday, aged 23 months, and while the death of a baby is always sad, Alfie’s death is especially sad. And terrifying. If you haven’t been following the case, here is the tl;dr:
Alfie was severely brain-damaged, the result of a brain disease so rare it doesn’t even have a name.
Doctors and nurses cared for Alfie and kept him alive with a respirator, until such time that medical staff felt further efforts were cruel, and certainly were not going to help. The medical staff asked Alfie’s parents to consider ending treatment.
Alfie’s parents declined. Against all odds, they wanted to keep trying to revive Alfie. As far as the parents could tell, Alfie was not suffering, and hope was not cruel to the little boy.
The British courts decided against Alfie’s parents and ordered the doctors to take the little boy off life support.
The Pope himself stepped in for the Catholic couple, and offered to pay all the expenses to transfer Alfie to a children’s hospital at the Vatican, where Italians would pick up all the expenses and Alfie would be allowed to live or die according to the will of God. Alfie was given Italian citizenship and a helicopter was on standby to transport the child, at no cost to the British public.
Doctors took Alfie off life support while the court decided Alfie’s parents had no say in how their little boy’s life was to end. The courts decided Alfie was not allowed to end his days at the Vatican hospital. Alfie was ordered to die in the British hospital.
Alfie refused to die. He was taken off life support, but the little boy simply refused to go gently into that good night.
He raged against the dying of the light.
The British courts refused to give Alfie, or his parents any glimmer of hope at all.
Alfie died six days later, in his father’s arms.
The rage this case has generated around the world has nothing whatsoever to do with healthcare, and everything to do with the over-reaching power of the state to decide who lives and who dies. It would not surprise me to know that most of Alfie’s Army, a group of protesters who gathered at the hospital where Alfie was sentenced to die, are women. Women are accustomed to the having the power to decide, based on any reason at all, which children live or die. One in four American women will terminate the life of her own child, legally. To see the state strip women of that power must be chilling indeed. Men have not had the power to legally determine the life and death of children for many, many centuries, but women hold that power now.
How tenuous the grip, at least in the UK.
There was never any doubt that Alfie was going to die, at least among reasonable people looking at scientific rationale. This is not to diminish or denigrate those, like the Pope, who are willing to include extreme outlier outcomes (miracles) in their calculus of care. What Alfie’s case was about is who has the power to decide how and when a child will die? Alfie’s parents, motivated by love, wanted to go to the bitter end and try every possibility, especially since Alfie seemed unharmed by the extension of this life. The medical team wanted Alfie to die quickly, and were prepared to withhold food and water from the child to hasten that death. Let’s presume the medical team are not monsters and were motivated by an ethic of care that required a quick and painless death.
Whose will prevails?
Even if we ascribe an ethic of pure care to the courts and the medical team – they intend no harm other than, you know, the death of a tiny child, do the courts carry more authority than the parents, and from whence is that authority derived?
We always come back to Nietzsche and his prophetic admonition: God is dead. When humanity does not have a higher power to bestow moral authority on us mere mortals, humanity will always choose death. If the parent’s will had prevailed, Alfie would have died in the Vatican, surrounded by people praying for his life. The best possible outcome would be a miracle, and Alfie restored to health and life. Instead, he died in a hospital, surrounded by technocrats, praying for his death. The best possible outcome would be death, quickly and painlessly. The path of the Gods typically involves life – persevering and making sacrifices and raging against the dying light. This is why we are so beloved of Gods, I think. The Gods help us cling to our lives, no matter how miserable, pointless and composed of endless suffering they might be.
God is life, even for atheists.
The state is death, even for the devout.
Think about that carefully. The British hospital and court system is no doubt filled with well-meaning individuals who are not heartless, cruel or murderous. They are voluntarily trapped in a system where the winning condition is, and can only be, death. No possible harm arose to the system by allowing Alfie to die in the Vatican under the care of those whose most fervent wish was for his life, but the system cannot allow life to prevail over death.
This is literally the choice before us, as a society. An ethic of life, or the horrors of the shade. Britain has chosen death. Now it is our turn.
Rest in peace, little angel.
Lots of love,