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Dr Ravi Jayaram shares thoughts on complex Charlie Gard case

Countess consultant paediatrician attempted to shed light on a difficult situation

Dr Ravi Jayaram, from the Countess of Chester Hospital(Image: Mark Johnson)

Paediatrician Dr Ravi Jayaram says the Charlie Gard case is both tragic and complex.

The Countess of Chester Hospital consultant shared an extensive post on his Facebook page.

Charlie, who is just 11 months old, has been on life support at Great Ormond Street Hospital since December 2016.

He suffers from a rare genetic condition called mitochondrial depletion syndrome.

This means the cells in his body cannot use energy appropriately, meaning his organs and muscles are very weak.

Charlie’s parents have raised more than £1m to take him to America for experimental treatment.

Doctors believe he has suffered irreversible brain damage and transporting him to the US could cause further pain and suffering.

Chris Gard and Connie Yates with their son Charlie Gard(Image: PA Wire)

Dr Jayaram’s full post is more than 2,000 words long. You can view the full version here. This is an extract:

“The fundamental question here has to be about what the longer-term expectation for Charlie is.

“If the outlook is dismal and his brain is not going to recover to the point where he will have any meaningful awareness of the world around him, and he will never be able to live independently of machinery, what possible good can come of prolonging the inevitable? However assessment of his brain function is the difficult one.

“He will already have undergone numerous objective assessments of his brain including MRI scans and electrical tests, and these are the best measure we have to work out the answer.

“Charlie’s parents disagree with the Neurologist’s opinions; I can only begin to imagine the agony they must be going through at being told that nothing more can be done, and their son is going to die, when they are convinced that the medical assessment of Charlie’s brain function is flawed. What parents would not try any treatment, whatever the risks, and however slim the chances of it working, to keep their child alive?

“I have been in several situations in my career as a paediatrician where I have had to discuss the recommendation to switch from active to palliative treatment.

“No parent ever wants to have to make that decision; I have never expected parents to make that decision without having adequate time, information and discussion, however long that takes.

“I have been lucky enough till now to have been able to find common ground and for joint decisions to be agreed as to which way to go.

“With time and open, honest discussion, doctors can understand parental viewpoints and vice versa. This is never easy for families but don’t believe that this is ever easy for the medical teams either. We are human too and I have shed tears many many times.”

Charlie’s parents and the hospital have been locked in an extensive legal battle.

The High Court, Supreme Court and European Court of Human Rights have all ruled with the opinion of doctors.

Dr Jayaram also said sections of the media had failed to represent all of the facts objectively.

He wrote: “The reality of these situations is never as black and white as what you will read over your cornflakes.

“The medical arguments will never be articulated in any detail, both because of their complexity but also because of issues around patient confidentiality.

“They can also seem very dry in comparison to the grief and anger of families.”

The story has attracted worldwide attention with even US President Donald Trump and Pope Francis going public with their opinions.

Dr Jayaram concluded: “Who knows what the outcome will be?

“But everyone involved must learn from this, so that the Charlie's of the future and their families can make the right decisions in the right ways, together with the medical teams caring for them, whatever those decisions may be.”

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