A High Court judge has ruled that it is not in the best interests of a severely brain-damaged toddler to continue receiving life-sustaining treatment, despite the devout wishes of his Muslim parents that he be kept alive.
The boy, identified only as TR, has Leigh syndrome, a severe and progressive congenital mitochondrial disease for which there is no cure. Following a respiratory arrest in January 2025, he has required mechanical ventilation and intensive care. Subsequent investigations confirmed extensive and irreversible brain damage.
Medical experts, supported by the child’s guardian, concluded that continuing treatment provides no appreciable benefit and is causing him harm. The Cardiff and Vale University Local Health Board sought a declaration that a palliative care plan would be in his best interests.
But the boy’s parents, described by the judge as ‘devoted parents who love and cherish their only child’, argued that he derives sufficient benefit from treatment to justify its continuation. They said their Islamic faith teaches that life and death are determined by Allah, not by human decision.
Delivering judgment in the Family Division, Mr Justice Garrido acknowledged the ‘immense spiritual distress and lifelong emotional trauma’ the decision would cause. But he concluded that the medical evidence was overwhelming.
‘I accept the wide body of expert evidence that has come to the stark conclusion that TR has suffered irreversible brain damage which has resulted in no cognitive awareness and from which there is no prospect of recovery,’ the judge said.
He noted that the boy’s mother had remained at his bedside since his admission, providing exemplary care. The court heard she believed her son showed signs of awareness, including blinking and responding to familiar voices and music.
But medical experts said such observations were not consistent with cognitive awareness. One described any suggestion of neurological improvement as a “tiny drop of water in the ocean of damage”.
The judge identified significant physiological burdens of continuing treatment, including risks of pneumonia, bone disease, fractures, and worsening respiratory failure.
‘It cannot be in TR’s best interests to wait for these, or any of these, likely burdens to manifest or become acute before consideration is given to ending treatment,’ he ruled.
The judge granted the declaration sought by the health board, paving the way for a palliative care plan. He stressed that the case had been decided solely on the boy’s welfare, which was the paramount consideration.
The family are appealing the decision.
Photo: Bret Kavanaugh
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