University Hospitals Bristol and Weston NHS Foundation Trust v Godfrey & Anor (Rev 2)

In an application concerning withdrawal of life-sustaining treatment from a child, the governing question is whether providing the treatment is in the child’s best interests. The assessment must consider welfare in its widest sense, including medical, social and psychological factors, the nature and prospects of the treatment, its likely outcome, and the child’s perspective. Parents’ views are important but cannot displace the child’s best interests. Where treatment is not in the child’s best interests, the court may declare that withholding or withdrawing it is lawful.

The Trust applied under the inherent jurisdiction for declarations that withdrawing mechanical ventilation from Danny Godfrey, a newborn infant with profound hypoxic-ischaemic brain injury, was lawful and in his best interests. Danny was represented by the Official Solicitor, who supported the application. His family also supported the proposed care plan. The court additionally considered whether steps could be taken to establish paternity and correct Danny’s birth registration.

1. Withdrawal of ventilation. The court granted the declarations sought. Danny’s clinical presentation, investigations and prognosis demonstrated devastating and irreversible brain injury. Continued active treatment was futile and offered no realistic prospect of meaningful benefit.
2. Best interests. The court applied the approach stated by Baroness Hale in Aintree University Hospital NHS Trust v James [2013] UKSC 67. The question was whether continued ventilation and associated treatment were in Danny’s best interests, rather than whether withdrawal was in his best interests. Welfare had to be considered in the widest sense, including the nature and prospects of treatment, its likely consequences, and Danny’s interests as understood through those caring for him.
3. The principle stated in Yates and Gard v Great Ormond Street Hospital for Children NHS Foundation Trust [2017] EWCA Civ 410 was applied: the child’s best interests prevail, even where parents hold an alternative view for understandable and well-motivated reasons.
4. The proposed care plan appropriately balanced the possibility that Danny might breathe independently against the absence of any realistic prospect of meaningful interaction or benefit. If independent breathing proved unsustainable, he was to be allowed a natural death with palliative care and pain relief. If breathing continued, nutrition, hydration and continuing review could preserve dignity and potentially permit care at home.
5. The court also relied on the statutory provisions concerning re-registration and declarations of parentage. It permitted and deemed applications under the relevant provisions so that, if paternity were established, Danny’s birth registration could reflect his parentage on both sides.