A “much loved 10-year-old little boy”, in pain and with just six months to live, is at the centre of a court battle between the Perth Children’s hospital and his parents.
According to the court judgment, his mother believes hospital treatment is killing him and that he will be “cured by God” if he can go home.
His father believes it is in the child’s best interests to be discharged “so that he can spend his last remaining months in an environment that is familiar to him, surrounded by his family and loved ones”, the judgment said.
But the hospital urgently applied to the court for orders to keep “Child A” in its care and to provide palliative care, amid fears the parents would try to remove him.
Western Australian family court judge Robin Cohen made holding orders restraining the parents from removing the child, and the case will be back in court on Thursday.
“The mother has expressed beliefs that the medical treatment currently being provided to Child A is killing him, and if he is discharged from hospital, he will be cured by God,” Cohen wrote in her judgment, which was based on submissions from the medical team treating him.
“Child A is a much-loved 10-year-old little boy. He has a 13-year-old sister, Child D,” Cohen wrote.
“Child A has approximately six months left to live.
“Child A’s quality of life has been severely impacted. He has no control over any body movement or function and experiences symptoms that are extremely painful, and equally importantly in my view, are likely to be frightening for him.”
According to Cohen’s judgment, his medical team do not believe that sending him home is a “viable option” because of the complexities of his care; the concern sudden changes could result in a deterioration; and “the significant concern they hold about his mother’s ability to meet Child A’s emotional, psychological, and physical needs, importantly in respect to pain management”.
According to the evidence given to the court, the mother believes “that the medical management of Child A’s condition will ultimately kill him” and the boy was malnourished because of the mother’s belief he could not tolerate feeds.
“There is concern about the mother physically and verbally abusing the father in the family home in front of Child D who apparently had to intervene,” Cohen wrote.
“This incident resulted in the father applying for and obtaining an interim family violence restraining order against the mother, the net effect of which is that she can only attend the family home if the father is not present and she is in the company of a support worker or nurse.”
Other concerns raised in the judgment included the mother using “a short-acting hallucinogen, which she apparently has both admitted and denied using”; presenting as if intoxicated; being “heavily sedated”; and “disappearing and being uncontactable for hours, sometimes days”.
The court was unable to contact the mother.
The father asked the judge “to view [the mother’s behaviour] from a lens of understandable grief and distress”.
According to Cohen’s judgment, the mother also said she did not support opiates, which led to concerns she would refuse to administer pain relief.
“Hospital staff report the mother stating that when Child A has dystonia [involuntary muscle contractions], his body is receiving a workout and is reaching euphoria,” Cohen wrote.
“Dr B opined that the mother’s presentation is consistent with an untreated mental health condition with psychotic features. He considers that she has no insight in respect of the same and that she is refusing mental health support,” Cohen wrote.
“To Dr B’s credit, he acknowledges that it is, in fact, beyond his expertise and knowledge base to formally diagnose the mother. However, it is his professional opinion that she currently does not have capacity to deliver a safe and caring environment for Child A or to make reason-based decisions about him.”
Cohen was critical of the communities department in her judgment after it agreed with the parents’ position, as long as there was “safety planning in place”, despite being aware “that “the mother grabbed the father around the throat and Child D was required to intervene”.
“Child A is a very vulnerable little boy, and all things being equal, he should be able to receive treatment at home, which is everyone’s desire,” Cohen wrote.
“However, at this stage, the concerns raised about the mother are so serious, that I do not consider it to be in his best interests to be discharged from hospital at the moment. There are currently too many unknowns.”
The case will return to court on Thursday, with some time given to the parents to respond.
