Beyond “Right” And “Wrong”: Plenary presentation by Sarah Barclay to the 5th International Conference on Paediatric Palliative Care, Cardiff 2010

1. Beyond Right and Wrong How mediation could help resolve contested decisions in paediatric palliative care Sarah Barclay Cardiff, July 2010

2. What are the ethical dilemmas?

4. Decision Making

6. What is the court being asked to decide?

7. ‘ Judges are given the appalling task of weighing up issues of immense sensitivity on which they have received little training – medicine, parental love, ethics and often religion’ Marcel Berlins The Guardian 23 March 2009

10. ‘ Court battle over hospital that wants to let baby die’ 26 September 2004

11. ‘ I’m hoping for a miracle,’ says Charlotte’s father. 2 October 2004

12. ‘ I can really think of little that would be worse than for a child to be intubated and die in the course of futile treatment, or, worse still, in the course of futile treatment while futile legal proceedings were on foot’ Mr Justice Hedley

13. The Baby OT case Parents ‘deeply distressed’ by court ruling to switch off life-support for their boy 21 March 2009

14. The Baby OT case Parents may sue hospital over right-to-die battle 23 March 2009

15. The Story Of Child B

16. Mediation An alternative solution

19. Mediation in the medical arena ‘ This plaque is dedicated to the memory of children and pre-viable babies who died and from whom organs were wrongly retained in former times. This dedication acknowledges the role of parents in bringing about appropriate change’ Memorial plaque, Alder Hey

20. ‘ There are potential advantages to using mediation in disputes about critical care decisions in neonatal medicine…’

21. A new approach Litigation Mediation Adversarial Consensual Inflexible Flexible Backward-looking Forward-looking Externally imposed judgment Mutually agreed solution Time-consuming Relatively quick Very costly Relatively cheap

23. So: What is it? How would it work?