Alder Hey Children's NHS Foundation Trust v Evans & Ors

In disputes concerning medical treatment and end-of-life arrangements for a child who lacks capacity, the governing test is the child’s best interests. Those interests prevail over the parents’ asserted rights where the court has determined the child’s best interests and the arrangements implement that determination. Habeas corpus is unavailable where the child is not unlawfully detained and the arrangements serve the child’s identified best interests. On a restoration limited to implementation, the court must address the practical details of the existing orders and must not reopen the central decision.

The court had previously determined that continued invasive treatment was inconsistent with Alfie Evans’s best interests. That decision was upheld on appeal, and permission to appeal to the Supreme Court was refused. The Court of Appeal’s order permitted the parties to return to the first-instance judge only if they could not agree the end-of-life plan or the date for withdrawal of artificial ventilation.

The case was restored on that limited implementation issue. The parents sought a writ of habeas corpus and challenged the arrangements, raising the central question whether the court should reopen the substantive best-interests determination or endorse the care plan proposed by the Trust.

1. Best interests. The applicable test was the child’s best interests. This was described as the gold standard for decisions concerning a child who lacks capacity. Once determined, the child’s interests prevailed over the parents’ rights.
2. Habeas corpus. The proposed writ was misconceived. Habeas corpus applies to unlawful detention or a compromise of civil liberty. There was no such compromise where the child’s identified best interests were being met through lawful arrangements endorsed by the court.
3. Limited remit. The restoration was confined to implementing the earlier orders. The Court of Appeal had not authorised any reopening of the central issues. The court therefore considered only the end-of-life plan and related practical arrangements.
4. Care plan. The parents had not engaged with the plan because they rejected the underlying decision rather than its particular terms. No unresolved implementation dispute properly remained. The court nevertheless considered the plan carefully and endorsed it, with the approval of the child’s guardian.
5. The child was entitled to peace and privacy at the end of life, and the final arrangements were endorsed accordingly.

• Court of Appeal: The earlier judgment was upheld. An order dated 8 March 2018 allowed return to the first-instance judge only to resolve disagreement about implementation of the end-of-life plan or withdrawal of artificial ventilation.
• Supreme Court: Permission to appeal was refused on 20 March 2018.
• European Court of Human Rights: The parents ultimately pursued the matter there; the judgment records that the earlier judgment was upheld.