text: LONDON -- The parents of a terminally ill British toddler whose case has drawn support from Pope Francis plan to return to the Court of Appeal Wednesday in hope of winning the right to take him to Italy for treatment. High Court Justice Anthony Hayden on Tuesday rejected what he said was the final appeal by the parents of 23-month-old Alfie Evans, who suffers from a degenerative neurological condition that has left him in a "semi-vegetative state." 
   
   The judge said his ruling "represents the final chapter in the life of this extraordinary little boy." 
   
   But Alfie's parents, who are backed by a Christian pressure group, have been granted a chance to challenge that ruling at the appeals court Wednesday afternoon. 
   
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   The months-long legal battle between Alfie's parents and his doctors has drawn interventions from the pope and Italian authorities, who support the parents' desire to have their son treated at the Vatican's children's hospital. 
   
   Doctors from Alder Hey Children's Hospital in Liverpool, where Alfie has been treated since December 2016, say he has little brain function and further treatment is futile. The toddler's life support was withdrawn Monday after a series of court rulings blocked further medical treatment. 
   
   Alfie's father Tom Evans said Alfie continued to survive with no assistance, and that doctors had subsequently resumed providing oxygen and hydration. 
   
   The family's lawyer claimed in court Tuesday that Alfie was doing "significantly better" than previously believed. 
   
   But the judge said "the sad truth" is that Alfie's condition had not improved. 
   
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   Doctors say it is hard to estimate how long Alfie will live without life support, but that there is no chance he will get better. 
   
   Pope Francis has met Alfie's father and made appeals for the boy's parents' wishes to be heeded, saying only God can decide who dies. 
   
   Italy has sent a military plane to Britain to transport Alfie to Rome if the courts allow it. Alfie has also been granted Italian citizenship to facilitate his arrival and transport. ||||| Image copyright Kate James Image caption Alfie Evans was taken off life support on Monday evening 
   
   The parents of seriously ill toddler Alfie Evans have launched a further appeal in a bid to take him abroad for treatment. 
   
   A High Court judge said the 23-month-old may be allowed home from Alder Hey Children's Hospital, where his life support was withdrawn. 
   
   But Mr Justice Hayden refused to allow Tom Evans and Kate James to move their son to a hospital in Rome. 
   
   The Court of Appeal judges have retired to consider their decision. 
   
   At the start of the hearing, three senior judges heard Alfie, whose life support was removed on Monday, was "struggling". 
   
   Jason Coppel QC, representing Ms James, said she had told him her son needed "immediate intervention". 
   
   'Clutching at straws' 
   
   Paul Diamond, acting for Mr Evans, told judges he had spoken to his client before the hearing, who had told him to "save my boy". 
   
   "He would leave no stone unturned... He is clutching at straws," he said. 
   
   Mr Diamond argued that there had been a "significant change of circumstances" because Alfie was still breathing after life support treatment stopped on Monday evening. 
   
   He said an "alternative" was available, and a military air ambulance was on standby "at the request of the Pope". 
   
   "We submit there is a likelihood of Alfie having some pleasure in life," Mr Diamond said. 
   
   But appeal judge Lady Justice King disagreed. 
   
   She said evidence showed that, while Alfie was unlikely to feel pain, "tragically everything that would allow him to have some appreciation of life, or even the mere touch of his mother, has been destroyed irrevocably". 
   
   Michael Mylonas QC, for Alder Hey Children's Hospital, said Mr Diamond had accepted "categorically" before the appeal court and before Mr Justice Hayden that "there is no new medical evidence to contradict the evidence" that was before the High Court in February. 
   
   "It was never suggested that death would be instantaneous." 
   
   He said Alfie has previously survived six to 10 days without a ventilator and it has "never been said to [his] family that Alfie would die immediately or before sundown". 
   
   Mr Mylonas said the "tragedy" for the parents was that Alfie looked like a normal child. 
   
   Outside court, two people believed to be German air ambulance staff were escorted from Alder Hey by police. 
   
   They were seen speaking to members of the Evans family. 
   
   Media playback is unsupported on your device Media caption Tom Evans plans to lodge an appeal as Alfie "is not struggling, he is fighting". 
   
   On Tuesday, his parents, backed by the Christian Legal Centre, brought a fresh application for Alfie to be moved from Liverpool to the Vatican-linked Bambino Gesu Hospital in Rome. 
   
   At a further hearing in Manchester, Mr Evans claimed his son had fared "significantly better" than expected after life support was withdrawn, suggesting his health had improved. 
   
   But Mr Justice Hayden rejected this, saying: "The sad truth is that it is not." 
   
   Instead, the judge said, Alfie's continued life was a "shaft of light" and a "special opportunity" for his parents to spend time with him - not the time for more legal manoeuvres. 
   
   He also criticised the "malign hand" of one of the family's advisers, law student Pavel Stroilov, who had, the court heard, been party to Mr Evans lodging a private prosecution of Alder Hey Hospital doctors, allegedly for murder. 
   
   Media playback is unsupported on your device Media caption BBC News went to meet the people calling themselves 'Alfie's Army' 
   
   He said the hospital had provided "world class" care for the child. 
   
   The best Alfie's parents could hope for, Mr Justice Hayden said, was to "explore" the options of removing him from intensive care either to a ward, a hospice or his home. 
   
   Roger Kiska, from the Christian Legal Centre, told the Victoria Derbyshire programme the judge's comments were "highly inappropriate". 
   
   Mr Kiska said the judge was speaking of "a private prosecution of anyone who delivered medicine, drugs, which would hasten Alfie's death, which is de facto euthanasia and a crime in this country". 
   
   A doctor, who cannot be named for legal reasons, said for Alfie to be allowed home would require a "sea change" in attitude from the child's family. 
   
   He told the court they feared that in the "worst case" they would try to take Alfie abroad. 
   
   Media playback is unsupported on your device Media caption Tom Evans says Alfie has been breathing without support 
   
   The toddler has been in Alder Hey since December 2016 with a rare undiagnosed degenerative neurological condition. 
   
   Medics have said Alfie's brain has been destroyed by his illness, and it is in his best interests to withdraw life support. 
   
   In a statement released after the hearing, Alder Hey Children's Hospital said its "top priority remains in ensuring Alfie receives the care he deserves to ensure his comfort, dignity and privacy are maintained throughout. 
   
   "This includes working closely with Kate and Tom as they spend this precious time together with him." 
   
   Mr Evans and Ms James had hoped Alfie could be taken to the Bambino Gesu Hospital in Rome, which has links to the Vatican, where his care could continue. 
   
   They have lost a series of legal challenges against a High Court ruling in February that Alder Hey could withdraw ventilation.
target: – A UK High Court judge may have deemed his decision Tuesday "the final chapter" in the case of little Alfie Evans, but Alfie's parents aren't ready to accept that ending. The BBC and Guardian report on the court's ruling that the seriously ill 23-month-old—who suffers from a rare degenerative neurological disorder and who was taken off life support Monday—can now return home from Alder Hey Children's Hospital or be placed in hospice, but that his parents, Tom Evans and Kate James, can't bring him to a Rome hospital for further treatment. Although Justice Anthony Hayden described the toddler as "a fighter, resilient, courageous and a warrior," he doesn't think further treatment will make any difference in Alfie's condition and that his parents should take this "special opportunity" to spend time with him, not waste it on what he sees as futile treatment and legal battles. Hayden also rejected claims by Alfie's father that the boy was doing "significantly better" after Alfie was said to have breathed without machinery for 20 hours after being taken off life support. "The brain cannot regenerate itself and there is virtually nothing of his brain left," Hayden argued. Alfie's parents are appealing Hayden's decision and tell the BBC they have an appointment at the appeals court set for Wednesday. They'd like Alfie to receive care at Bambino Gesu Hospital, which has ties to the Vatican. "I'm not giving up because Alfie is breathing away," Evans says. "He is not suffering, he is not struggling; he is fighting." Both Pope Francis and Italian authorities have supported the family's desire to bring Alfie to Rome, with the pope saying "only God can decide who dies," per CBS News. (Alfie's case is reminiscent of that of baby Charlie Gard, who died last summer.)