Legal and Ethical Issues of Discontinuing Futile Therapy in Children

This article raises the issue of critical medical decisions made in the interest of small children. It seeks answers to the questions of whether there are any differences in this field’s attitude towards adults and what the criteria for life and death decisions should be for persons who are legally dependent and unable to declare their position. The concept of so-called parental autonomy in making treatment decisions for children and situations in which they may be limited by the assessment of doctors and by the supervisory function of the guardianship court. The overriding principle of the best interests of the child is compared with the British concept of best interest and is confronted with the newer concept of threat of serious harm, which is considered better at respecting privacy and giving parents more powers. The mechanism of conflict resolution between parents and doctors is shown through the example of court decisions in the cases of Charlotte Wyatt, also known in Poland, Charlie Gard and Alfie Evans, and then is transferred to the Polish example of Madzia Weakling. The considerations end with the conclusion that the best interests criterion is pragmatic and a non-principal development of the principle of the best interests of the child, within the context of protection against the unbearable suffering of living or dying in agony, which is also important.