BMJ 2015;351:h5141 doi: 10.1136/bmj.h5141 (Published 24 September 2015)
Page 1 of 1
News
NEWS Parents of boy with brain cancer put him at risk when they took him from hospital, report finds Clare Dyer The BMJ
The parents of Ashya King, a boy with brain cancer, put him at risk when they removed him from Southampton General Hospital without notice, after losing trust in his doctors, and took him abroad for proton beam therapy, a report from Portsmouth Safeguarding Children Board has concluded.1
parents could take him to Prague for proton beam therapy.3 He had the treatment and this month returned to the Proton Therapy Centre in Prague, whose director was quoted as saying that he was “doing fantastically.”
One relevant factor in the breakdown of trust was a delay in obtaining a second opinion for the parents, Brett and Naghmeh King. The report said, “Whilst the doctors’ view that this was not needed immediately was accurate in terms of the child’s clinical needs, this failed to take account of the indirect message that was given to the parents, which was that their wishes and rights were overruled by the professionals.”
“Once the parents had removed the child from the hospital there were limited options available to the agencies as there were real concerns that he was at immediate risk of significant harm,” the report said. “These concerns were partly a result of the parents concealing the actions they had taken to ensure his safety and were compounded by them failing to respond to attempts to contact them.
The boy, then 5 years old, had had surgery for a medulloblastoma in August 2014 and was being fed through a nasogastric tube and was at risk of serious harm if “anything untoward” had happened to the tube, the report said.
The authorities’ heavy handed approach sparked a media outcry and intervention from senior politicians, including the prime minister, David Cameron. But the safeguarding board’s review concluded that the agencies had acted appropriately and that there was little that could have been done differently.
The Kings wanted Ashya to have proton beam therapy, which is not available in the United Kingdom but can be funded by the NHS abroad in suitable cases. Hospital staff told the Kings that it was not deemed to be the appropriate treatment for medulloblastoma and that it would therefore not be paid for by the NHS.2
“The legal options available to agencies were draconian and did not allow for any flexibility in application.” The only legal mechanism to safeguard a child who was taken abroad was wardship, which has restricted powers. “Once the parents were arrested, the matter was managed by the Spanish judiciary and no UK agency had direct influence on the decision-making.”
The Kings drove Ashya and his siblings to Portsmouth ferry terminal and were in France by the time hospital staff realised that he was missing. The Kings travelled to their holiday flat in Malaga, where they were arrested by Spanish police under a European arrest warrant issued by the Crown Prosecution Service on the application of Hampshire police.
The parents were taken to a prison in Madrid to await extradition proceedings, while Ashya was in a hospital in Malaga 500 km away. They spent two days in prison before the prosecution service withdrew the arrest warrants and they were released. Ashya had been made a ward of court, and after it became clear that he was not in danger the High Court made an order that his
For personal use only: See rights and reprints http://www.bmj.com/permissions
thebmj.com Observations: Lessons from the Ashya King case (BMJ 2014;349:g5563, doi:10.1136/bmj.g5563) 1 2 3
Portsmouth Safeguarding Children Board. Executive summary of the lessons learned from a review of interagency working with a child in acute care. Sep 2015. www. portsmouthscb.org.uk/wp-content/uploads/EXECUTIVE-SUMMARY-Final-5-9-15.pdf. Dyer C. Boy at centre of legal wrangle is expected to be treated in Prague. BMJ 2014;349:g5495. Dyer C. Judge rules that boy with brain cancer can be treated in Prague. BMJ 2014;349:g5570.
Cite this as: BMJ 2015;351:h5141 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
News
NEWS Parents of boy with brain cancer put him at risk when they took him from hospital, report finds Clare Dyer The BMJ
The parents of Ashya King, a boy with brain cancer, put him at risk when they removed him from Southampton General Hospital without notice, after losing trust in his doctors, and took him abroad for proton beam therapy, a report from Portsmouth Safeguarding Children Board has concluded.1
parents could take him to Prague for proton beam therapy.3 He had the treatment and this month returned to the Proton Therapy Centre in Prague, whose director was quoted as saying that he was “doing fantastically.”
One relevant factor in the breakdown of trust was a delay in obtaining a second opinion for the parents, Brett and Naghmeh King. The report said, “Whilst the doctors’ view that this was not needed immediately was accurate in terms of the child’s clinical needs, this failed to take account of the indirect message that was given to the parents, which was that their wishes and rights were overruled by the professionals.”
“Once the parents had removed the child from the hospital there were limited options available to the agencies as there were real concerns that he was at immediate risk of significant harm,” the report said. “These concerns were partly a result of the parents concealing the actions they had taken to ensure his safety and were compounded by them failing to respond to attempts to contact them.
The boy, then 5 years old, had had surgery for a medulloblastoma in August 2014 and was being fed through a nasogastric tube and was at risk of serious harm if “anything untoward” had happened to the tube, the report said.
The authorities’ heavy handed approach sparked a media outcry and intervention from senior politicians, including the prime minister, David Cameron. But the safeguarding board’s review concluded that the agencies had acted appropriately and that there was little that could have been done differently.
The Kings wanted Ashya to have proton beam therapy, which is not available in the United Kingdom but can be funded by the NHS abroad in suitable cases. Hospital staff told the Kings that it was not deemed to be the appropriate treatment for medulloblastoma and that it would therefore not be paid for by the NHS.2
“The legal options available to agencies were draconian and did not allow for any flexibility in application.” The only legal mechanism to safeguard a child who was taken abroad was wardship, which has restricted powers. “Once the parents were arrested, the matter was managed by the Spanish judiciary and no UK agency had direct influence on the decision-making.”
The Kings drove Ashya and his siblings to Portsmouth ferry terminal and were in France by the time hospital staff realised that he was missing. The Kings travelled to their holiday flat in Malaga, where they were arrested by Spanish police under a European arrest warrant issued by the Crown Prosecution Service on the application of Hampshire police.
The parents were taken to a prison in Madrid to await extradition proceedings, while Ashya was in a hospital in Malaga 500 km away. They spent two days in prison before the prosecution service withdrew the arrest warrants and they were released. Ashya had been made a ward of court, and after it became clear that he was not in danger the High Court made an order that his
For personal use only: See rights and reprints http://www.bmj.com/permissions
thebmj.com Observations: Lessons from the Ashya King case (BMJ 2014;349:g5563, doi:10.1136/bmj.g5563) 1 2 3
Portsmouth Safeguarding Children Board. Executive summary of the lessons learned from a review of interagency working with a child in acute care. Sep 2015. www. portsmouthscb.org.uk/wp-content/uploads/EXECUTIVE-SUMMARY-Final-5-9-15.pdf. Dyer C. Boy at centre of legal wrangle is expected to be treated in Prague. BMJ 2014;349:g5495. Dyer C. Judge rules that boy with brain cancer can be treated in Prague. BMJ 2014;349:g5570.
Cite this as: BMJ 2015;351:h5141 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
