In another recent blood transfusion case, concerning DV, a 17⅓-year-old young man suffering from pulmonary osteosarcoma, it was revealed that Shane Brady was refused permission to appeal the above-mentioned decision of Sir Judge Munby. Mr Brady also represented DV and unsuccesfully attempted to re-run the arguments already rejected.
Some more words about DV and his case. The judge describes him as "a remarkable young man, who has been through the wars, enduring repeated cycles of chemotherapy as well as the amputation of his leg and repeated physiotherapy; yet, he has made himself a career and is doing extremely well in his metal work and engineering. He has the admiration of his colleagues. He has coped with what life has thrown at him and has gained the respect of those who come into contact with him. He has close friends and a very supportive family. He finds great comfort in his faith, and I have read much about him to his credit, not all repeated in this judgment to save his blushes."
He was 13 years old when he was first diagnosed with osteosarcoma and received a transfusion, after which he developed PTSD. An year later, he said "he began to think more and more about whether he himself wanted to become one of Jehovah's Witnesses," but at the age of 15⅔, in the middle of a two-years-long period of remission, he was baptized. Now he needs another surgery on the right lung, which has already been cancelled once because of his objections to blood transfusion.
What makes DV's case different is that the hospital didn't asked to authorize a transfusion. The NHS Trust sought "declarations that it is lawful, and in DV's best interests, that first, he should have the pulmonary metastasectomy under general anaesthetic, and secondly that the treating clinicians will not take steps towards providing him with a transfusion of whole blood, be that red cells, white cells, plasma and platelets, against his wishes." The hospital itself provided factors against use of blood products, like DV's age, the strength of his objections, potentional psychological harm, low risk (1%) of haemorrhage, danger of DV becoming reluctant to future surgery, and practical impossibility to force him to go to hospital against his will.
"The treating team agree that the single most important thing is that he has the surgery and to secure that, there must be agreement and certainty that blood products should not be used. I would like to thank the hospital and its staff for its responsible and sensible handling of the case and the assembly of a team who have all guaranteed to honour their word that no blood products will be used. So the clear view of the treating team is that to give DV blood products would be damaging to his welfare and counterproductive in all the ways that I have mentioned."
So, why to sought a court order at all if there is no serious controversy? To make sure the clinician's tough decision is right and won't be challenged; to secure the surgery will take place as soon as possible; and to prevent establishing a precedent Shane Brady wishes to achieve.
"The clinicians find it a finely balanced decision in circumstances where, firstly, they are acting against their training and instinct by determining in advance that they will not avail themselves of what might be a life-preserving form of treatment, and secondly, they wish the court to make the decision. Thirdly, this is not in any sense a trivial decision, and to see the difficulty, look what happened on 1 March 2021 where the procedure was planned, but did not take place for the reasons given. Fourthly, the court has the power to make the decision about medical treatment which may or may not have the consent of the young person, and even a 17 year old does not have the absolute right to determine what his or her treatment should be, and to provide that, even in these relatively non-contentious circumstances, a minor has the right to decide his treatment overthrows decades of legal authority."