Alfie Evans and the Post-Familial World

By now the tragic story of Alfie Evans is well known. The English toddler with an undiagnosed neurodegenerative disorder died last week, five days after doctors extubated him and abandoned all treatment, except palliative care. A judge denied Alfie’s parents the right to transport him to another hospital to extend treatment and life-support, even though Italy offered to transport him to the Vatican’s Bambino Hospital at no cost to Alfie’s parents or England’s National Health Service. Alfie was barred from leaving Liverpool’s Alder Hey Hospital because, in such cases, a judge has the authority to determine the best interests of the child. Here, it was apparently in Alfie’s best interests to die.

It appears the judge in this case acted entirely within the bounds of English law. And that’s the problem. The Children Act of 1989 is far-reaching legislation that puts the question of the child’s interests, when parents and doctors disagree, in the hands of a judge alone. Pitted against the medical establishment and the cool expertise of disinterested doctors, parents are at a disadvantage when arguing before the court. The doctors have case studies, statistics, expert testimony, and all the weight of the academy on their side. All parents have is love and the bonds of parental affection.

Even granting that sometimes parents lack the capacity to make decisions regarding the welfare of their children and that prolonging life at all costs by any means is not always the moral choice, we intuitively know when Tom Evans was denied the ability to transport his son to another hospital, he was denied a basic parental right. The duty to protect and provide for a child naturally belongs to his father. But this is traditional wisdom our culture routinely ignores.

We think we can substitute a judge for a father, a state for a family. But when we do, a toddler is left to die without so much as an IV of cool water for the least of these. After having his breathing support removed, Alfie continued to live, breathing on his own, but, reportedly, was then denied adequate nutrition. Now, it does not take an advanced degree in bioethics to know you don’t starve a disabled toddler—just basic human decency. But that’s what we lose in the technocratic state.

“The Coming World of Post-Familialism”

Last Sunday, Ross Douthat wrote about Alfie Evans with his usual clarity, and in the process highlighted several other cases where families had to fight the “medical-judicial complex” to care for their young or elderly loved ones. Douthat noted that our current system “is custom-built for the coming world of post-familialism, the world bequeathed to us by sexual individualism and thinning family trees.”

We have eschewed the traditional family in favor of free sex and the corporate machine. We have traded ties and affections for a steady paycheck and a few cheap thrills. We divorce and think our society will not fracture along the same fault lines. God made households the building blocks of society, but we think the autonomous individual self can do the trick. But who will care for care for us when we are aged and ill? Who will fight for our lives when we are infant and comatose? Who is the safety net when life derails? Who will step in and help when one makes a misstep in the “success sequence?”

Traditional wisdom says the family, held together by the bonds of love and loyalty, is best suited for these tasks. But in our rootless and atomized society, fractured by encouragements to “follow your heart” and “you do you,” the administrative state assumes the responsibilities of family, and, in return, demands the loyalty due one’s kin. When we do away with fathers, the state becomes our Mother. And no matter how much she protests she is only looking out for the best interests of the children, she is not a kind mother. She is more akin to Hansel and Gretel’s wicked stepmother, leaving the burdensome kids to starve in the woods.

Or the pediatric wing.

Photo by Hoshino Ai on Unsplash

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