Archie_Battersbee_case

Archie Battersbee, a British boy, was the subject of several court hearings between April and August 2022, regarding whether or not to withdraw his life support, after he was found unconscious and subsequently considered to have suffered brainstem death. The courts ruled in favour of Barts Health NHS Trust, and against his parents, and allowed his life support to be withdrawn.

# Incident

On 7 April 2022, a 12-year-old boy, Archie Battersbee,  from Southend, Essex, England, was found unconscious by his mother, Hollie Dance, with a dressing gown cord around his neck [1]. Dance performed CPR, and called for an ambulance. The paramedics who attended found that Archie Battersbee had suffered a cardiac arrest and his Glasgow Coma Scale score was three, the lowest possible, indicating "no eye-opening, verbal or motor response" [2]. CPR was continued and he was taken to Southend University Hospital [3]. On arrival at the hospital, he had no pulse, before regaining spontaneous circulation around 40 minutes after his mother had found him unconscious [3]. It was believed that Battersbee sustained brain damage during this cardiac arrest, due to a lack of oxygen and blood supply to the brain, and for a sustained period [2]. He was transferred the next day to the Royal London Hospital [2]. Dance stated that she believed Battersbee was taking part in a dangerous TikTok phenomenon known as the "blackout challenge". This claim of a link to TikTok was broadcast on ITV's This Morning, but ITV subsequently apologised, claiming there was no evidence that Battersbee viewed this particular challenge via TikTok and also noting that TikTok does act to remove dangerous content [4] [5] [6]. On 8 November 2022, during a pre-inquest hearing, the Essex's senior coroner Lincoln Brookes said there was no evidence that Battersbee had been taking part in an online challenge [7]. 

# Legal cases

Battersbee's parents had refused permission for the hospital to perform brainstem testing. On 26 April, the Barts Health NHS Trust made two applications to the High Court of Justice: one for a Specific Issue Order, under section 8 of the Children Act 1989, that it was lawful for Battersbee to undergo brainstem testing, in accordance with the Academy of Medical Royal Colleges’ 2008 Code of Practice for the Diagnosis and Confirmation of Death, to establish whether he was brainstem dead. The other application, should the first fail, was for the Court to consider whether it was in Battersbee's 'best interests' to continue receiving ventilation assistance. Both requests were opposed by the parents, who had the support of the Christian Legal Centre. A further party introduced to proceedings was Battersbee himself, represented by a guardian appointed by the Children and Family Court Advisory and Support Service (CAFCASS). Subsequent appeals made by the family were heard by the Court of Appeal,  and finally by the Supreme Court [2] [2]. The NHS Trust argued that Battersbee's treatment should discontinue as he was considered 'brainstem dead', and thus had no hope of recovery. Battersbee's parents had argued that he "needed more time to heal", and that his own religious beliefs should be taken into account, his mother saying that "it is for God to decide what should happen to Archie, including if, when and how he should die."  Battersbee's family also requested the interventions of the United Nations' Committee on the Rights of Persons with Disabilities, which appeared to have no jurisdiction over the case, as well as the European Court of Human Rights (ECHR), which subsequently declined to hear the case [10]. The English courts, noting that the Children Act 1989 requires decisions at all stages of a case to be made with the child's welfare being of paramount importance,  repeatedly ruled that Battersbee's treatment should end, and all appeals made by the family against the courts' rulings – with the exception of one legal point; that Battersbee was not already legally 'dead' – were denied [11]. His life-supporting equipment, including mechanical ventilation, was finally withdrawn on 6 August 2022 and Battersbee was pronounced dead shortly afterwards at 12:15 BST [2]. 

# Inquest

On 12 August 2022 at Essex Coroner's Court, the inquest was opened into Battersbee's death by Lincoln Brookes, the senior coroner for Essex. It was confirmed that the cause of death was "catastrophic hypoxic ischemic brain injury, secondary to strangulation". The court heard that Battersbee had sustained the brain injury whilst at home [27]. A full inquest was scheduled for 7 February 2023 [3]. On 8 November 2022 a pre-inquest review heard from the Brookes that there was "no evidence" that Battersbee was taking part in an online challenge at the time of his death [3]. Police concurred with the coroner's statement that "it's low mood we're looking at here, very low mood."  The pre-inquest review confirmed that the full inquest would consider Battersbee's "state of mind and his intentions" [15] [14]. On 8 February 2023 Brookes concluded that Battersbee "had not intended to harm himself but had done inadvertently during a prank or experiment that went wrong" [15]. 

# Timeline

# Third party involvement and media analysis

## Christian Legal Centre

Lawyers from the Christian Legal Centre represented Battersbee's family in the case. In some court hearings, the family was represented by CLC consultant Pavel Stroilov [38] [39]. During his work on the Alfie Evans case, a judge described Stroilov as a "fanatical and deluded young man" whose "malign hand" was "inconsistent with the real interests of the parents' case." [38] [39] [40]. Neena Modi, professor of neonatal medicine at Imperial College London, raised concerns over exploitation with openDemocracy and said that the Christian Legal Centre "preys upon  [families like Archie's] when they are absolutely at their most vulnerable."  Professor Modi added that: [38]. In August 2022, The Guardian ran analysis on how third parties can further complicate tragic life support cases in the context of the Archie Battersbee case. Legal affairs correspondent, Haroon Siddique, noted that: "recent years have brought increasing intervention by religious groups purporting to support parents but who have also been accused of inflaming tensions."  Siddique's analysis concluded that "The involvement of such third-party ideologues presents a significant obstacle to the laudable aim of resolving such sensitive cases in a less adversarial manner." [40] [40]. 

## MP's letter for treatment abroad

During court proceedings, a judge was told that James Duddridge, MP for the family's constituency, had written on their behalf to the Royal London Hospital on August 3. The letter lobbied for treatment abroad despite there being "no detail as to what is actually sought and where."  A consultant paediatric neurologist told the court (via a written statement) that they were unaware of any treatment that could reverse the condition of Battersbee's brain [41] [41]. Duddridge has not confirmed if he is the author of the letter. Speaking via the Science Media Centre, Professor Dominic Wilkinson, Professor of Medical Ethics and Consultant Neonatologist, University of Oxford stated that "there are no treatments in Japan or Italy or anywhere else that offer any prospect of helping Archie" adding that: [42]. 

## GoFundMe page

In June 2022, Conservative MP for Southend West Anna Firth asked her Twitter followers to donate to a GoFundMe page connected to the case in a tweet that read, "The whole House is behind Archie and his family."  Firth had also donated to the fundraiser [38]. The fundraiser was launched by a Southend resident, although an update on the page stated that administrative control was given to Archie's sister-in-law [43]. The fundraiser made clear that funds would be used for anything needed by the family and did not rule out donations to third parties. On August 11, 2022, a statement from Christian Legal Centre's director, Andrea Minichiello Williams, stated that:. 

# Family campaigns

In August 2022, Hollie Dance called for unspecified legal changes and a public inquiry in the aftermath of her son's death. Dance also sought a meeting with UK Health Secretary, Steve Barclay, to discuss the perceived implications of the case [45]. The content of her letter was released by Christian Concern. 

# References

[1] https://news.sky.com/story/archie-battersbee-12-dies-after-life-support-is-turned-off-12633585
[2] https://www.judiciary.uk/wp-content/uploads/2022/06/Archie-Batteresbee-judgment-2-1.pdf
[3] https://www.itv.com/news/anglia/2022-08-12/archie-battersbees-death-a-tragedy-inquest-hears
[4] https://www.itv.com/news/anglia/2022-08-02/fight-for-archies-life-at-final-stage-says-mum
[5] https://www.theweek.co.uk/news/uk-news/957625/archie-battersbee-the-laws-of-life-and-death
[6] https://www.nationalworld.com/news/uk/archie-battersbee-appeal-online-blackout-challenge-3722480
[7] https://www.essexlive.news/news/uk-world-news/itvs-morning-forced-apologise-after-7190720
[8] https://www.bbc.com/news/uk-england-essex-63557850
[9] https://www.bbc.co.uk/news/uk-england-essex-62389726
[10] https://www.bbc.co.uk/news/uk-england-essex-61829522
[11] https://www.judiciary.uk/judgments/hollie-dance-and-paul-battersbee-v-barts-health-nhs-trust-and-another/
[12] https://www.bbc.co.uk/news/uk-england-essex-62346354
[13] https://www.bbc.com/news/uk-england-essex-62517728
[14] https://www.theguardian.com/uk-news/2022/nov/08/no-evidence-archie-battersbee-engaged-in-online-blackout-game-coroner-says
[15] https://www.bbc.com/news/uk-england-essex-63557850
[16] https://www.bbc.com/news/uk-england-essex-64568698
[17] https://www.bbc.co.uk/news/uk-england-essex-62307648
[18] https://www.bbc.co.uk/news/uk-england-essex-62323838
[19] https://www.bbc.co.uk/news/uk-england-essex-62376552
[20] https://www.theguardian.com/law/2022/aug/02/archie-battersbee-parents-fail-to-stop-planned-withdrawal-of-life-support-treatment
[21] https://www.supremecourt.uk/news/dance-and-battersbee-v-barts-health-nhs-trust-permission-to-appeal-decision.html
[22] https://www.bbc.co.uk/news/uk-england-essex-62403993
[23] https://www.bbc.co.uk/news/uk-england-essex-62418257
[24] https://www.bbc.co.uk/news/uk-england-essex-62444331
[25] https://www.bbc.com/news/uk-england-essex-62346354
[26] https://www.bbc.co.uk/news/uk-england-essex-62455467
[27] https://www.bbc.com/news/uk-england-essex-62517728
[28] https://www.bbc.co.uk/news/uk-england-essex-62889234
[29] https://www.theguardian.com/uk-news/2023/feb/08/archie-battersbee-death-accident-coroner
[30] http://www.bailii.org/ew/cases/EWHC/Fam/2022/1165.html
[31] https://www.judiciary.uk/judgments/barts-health-nhs-trust-v-dance-battersbee/
[32] https://www.judiciary.uk/judgments/dance-battersbee-v-barts-health-nhs-trust-and-another/
[33] https://www.judiciary.uk/judgments/barts-health-nhs-trust-v-battersbee/
[34] https://www.judiciary.uk/judgments/hollie-dance-and-paul-battersbee-v-barts-health-nhs-trust-and-another-court-of-appeal-civil-division-judgment/
[35] http://www.bailii.org/cgi-bin/format.cgi?doc=/ew/cases/EWCA/Civ/2022/1106.html&query=(battersbee)
[36] https://hudoc.echr.coe.int/app/conversion/pdf/?library=ECHR&id=003-7401248-10125292&filename=Request%20for%20interim%20measures%20refused%20in%20case%20concerning%20the%20withdrawal%20of%20life%20sustaining%20treatment.pdf
[37] https://www.judiciary.uk/judgments/barts-health-nhs-trust-v-holly-dance-and-others/
[38] https://www.opendemocracy.net/en/archie-battersbee-christian-legal-centre-preying-whitewash/
[39] https://www.pinknews.co.uk/2018/04/26/anti-lgbt-alfie-evans-christian-legal-centre-christian-concern/
[40] https://www.theguardian.com/society/2022/aug/01/archie-battersbee-another-tragedy-highlights-need-for-independent-mediation-in-cases-of-children
[41] https://www.judiciary.uk/judgments/barts-health-nhs-trust-v-holly-dance-and-others/
[42] https://www.sciencemediacentre.org/expert-reaction-to-the-latest-in-the-archie-battersbee-case/
[43] https://www.echo-news.co.uk/news/20183785.archie-battersbee-visited-hospital-southend-mp-anna-firth/
[44] https://christianconcern.com/comment/top-12-myths-of-archie-battersbees-case/
[45] https://www.independent.co.uk/news/uk/home-news/archie-battersbee-mum-inquiry-law-b2148516.html
[46] https://metro.co.uk/2022/08/20/archie-battersbees-mum-hits-out-at-tiktok-challenge-17215752/