Alfie Evans has been nationalised: he is under the ownership of the state

The case of Alfie Evans, the 23-month-old boy whose life support Alder Hey Hospital is proposing to switch off, has a significance that goes beyond the usual life-and-death controversies that regularly arise in medical jurisprudence. Alfie’s parents, in what can only be their last legal resort, have appealed to the Supreme Court to revisit the issue and permit them to take their son to Rome for further treatment, either experimental or palliative.

The reality, however, is that this controversy is no longer chiefly about one child’s life, precious though that undoubtedly is: it is a battle over family and parental rights, the fundamental English constitutional guarantee of Habeas Corpus and, above all, a clash of cultures. That conflict, of which the Brexit vote was the first seismic intimation, reflects an increasingly fissiparous divide between the elites that constitute the British establishment and the wider population that has lost confidence in all our national institutions.

Firstly, to put the medical context in perspective, any reasonable person accepts that, as medicine has become the victim of its own success, situations will arise where a patient who formerly would have died can be kept alive artificially in the hope of being either cured or restored to a stable condition of life. If that hope is frustrated, with no prospect of improvement, withdrawal of life support may become the only appropriate course of action, though only after rigorous ethical assessment.

In the case of Alfie Evans the clinicians insist he is beyond any hope of a cure; distressing evidence at court hearings has described a neuro-degenerative disease – never specifically diagnosed – that has progressively eradicated the majority of white matter in his brain and left it mainly composed of water and spinal fluid. Even his parents, while claiming to have detected some minor improvement in his condition, which may be parental wishful thinking, have conceded he is unlikely to live.

Their wish is to take him to the Bambino Gesù hospital in Rome where he would be assessed for the possibility of some experimental treatment and, at the least, given palliative care. In any civilized society, and under UK law, those parental wishes must be respected, unless doing so would have a detrimental effect on Alfie. Alder Hey Hospital contends that it is in Alfie’s best interests to remain there and have his life support withdrawn – a proposition a priori difficult to defend.

The courts should never have been involved in this case. When Alfie Evans’s parents announced they had a ventilator ready to transport their son to John Lennon Airport, Liverpool, where a jet would fly him to Rome and an assured place at the Bambino Gesù hospital, the only question that should have arisen was whether all this was correct, reinforced by inspection of the amenities to ensure they were adequate for Alfie’s needs. If that turned out to be the case, his parents should have been permitted to discharge him from Alder Hey without challenge.

It should further be noted that no cost would have been incurred by UK taxpayers, the resources devoted to Alfie would have become available to another patient and the duty of care towards this child would have been fully discharged by Alder Hey Hospital. Why, then, did the hospital insist on keeping Alfie on its premises, with the declared intention of ending his life as soon as the courts might legally permit it?

One would have thought – always with the caveat that the transport arrangements were medically adequate – that any group of clinicians would have been relieved to have this ethical dilemma and its unhappy eventual outcome removed from their responsibility. Why resist the parents’ rights in, successively, the High Court, the Court of Appeal, the Supreme Court, the European Court of Human Rights and, finally, the Supreme Court again?

It is this dog-in-the-manger attitude that has provoked the outcry on social media, more than 21,000 signatures on a petition in just four days and “Alfie’s Army”, the vociferous group of supporters who have protested at Alder Hey on his behalf. For the most part, these are lay people who know nothing about neuro-degenerative disease, cerebral white matter, or any of the other medical technicalities rehearsed by Alder Hey doctors, but they have grasped one key fact: that the medical and judicial establishment is determined to kill this child rather than release him to the care of a foreign hospital.

For the establishment, keeping Alfie Evans at Alder Hey and ending his life there has, in the public perception, become a virility symbol. Challenges on social media and unruly demonstrations by “Alfie’s Army” merely confirm the establishment’s belief that it is defending humane medicine and the dispassionate application of the law against ignorance and mob rule. What better scenario to enlist the support of broadsheet readerships, university graduates and all self-consciously enlightened people?

It resembles the Brexit confrontation. In particular, the less than persuasive utterances from the judicial bench have a classic resonance of the pronouncements we have heard so often from our elites. When Alfie’s parents attempted to secure his release from Alder Hey by invoking Habeas Corpus, the learned judges’ verdict was: “In our view the arguments advanced on behalf of the parents provide no basis on which Alfie could be said to be detained.”

Except that when his parents attempted to remove him from Alder Hey the police threatened his father with arrest. If Alfie is not detained, why is he not on a flight to Rome, as his parents wish? Two cardinal principles of law have been quashed at one stroke: the paramount right of parents to decide what happens to their children provided it involves no harm to them and the ancient British guarantee of Habeas Corpus.

Neither the doctors nor judges have established to any intelligent person’s satisfaction that the Vatican-sponsored removal of Alfie to Italy would cause him any harm. Can the same be said of leaving him at Alder Hey to have his ventilator switched off? What is at stake here is the ever-diminishing authority of parents over their children in opposition to the intrusive State. State encroachment upon family life, in a country where underage girls can be given abortions without their parents’ knowledge, has in recent decades been sinister and relentless.

Alfie Evans has been nationalized: he belongs not to his parents but to the state. Yet because of the Remainer-style snobbery that the establishment’s PR deploys to attract “sophisticated” people to its support, many who deplore socialism when it appears in a Momentum tee-shirt will parrot guff about clinicians knowing best and the impertinence of the untutored rabble in challenging judicial wisdom – the familiar phenomenon of recent years whereby the formerly Tory-minded classes have been converted into a nomenklatura.

Parents may think twice before they entrust their children to hospitals from which they may never retrieve them. Perhaps hospital administration should be transferred to the Prison Service. The case of Alfie Evans is desperately sad, but it is only the forerunner to an escalating conflict between the public and an establishment that is currently in the half-way house of having lost its authority, but not yet its power.