A second opinion

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There are bigger, more globally grave stories in the news, but this one has gnawed away at me over all of them for the past four days: that of Ashya King, the five-year-old with an aggressive brain tumour whose parents, Brett and Naghmeh King, are currently under arrest in Spain after removing him from the Southampton hospital where he was being treated. I’ve attempted to engage in a dialogue about the heartbreaking story as it unfolded via social media, but keep encountering people who I’ll generously describe as fence-sitters.

My reaction to the facts as they keep emerging has generally been a visceral one: that of disbelief, empathy and anger. Anger that when the seemingly well-informed, well-prepared and determined parents of a sick boy remove him from hospital care in order to seek an alternative, less scattershot radiation treatment which is not freely available on the NHS except in very rare circumstances – a treatment they were willing to pay around £100,000 for – are criminalised for taking this step. The parents, and the most tech-savvy of Ashya’s six elder siblings, Naveed, seem entirely fluent in the power of social media, and have been posting regular YouTube videos explaining their position.

Although it’s ten minutes long – and what’s ten minutes compared to the life expectancy of a five-year-old with a tumour on his brain stem? – I have been urging people to view father Brett King’s key testimony, in which Ashya appears, apparently relaxed and well cared for in a hotel in Vélez-Málaga. (They’d taken him to Málaga – not “snatched” him, in the alarmist words of the first media reports – in order to sell a holiday apartment to raise the money to pay for “proton beam” treatment in the Czech Republic.)

Although, as the fence-sitters have been quick to point out, we cannot know the full, transcribed conversations that have taken place between the Kings and the oncologists at University Hospital Southampton, Brett makes a clear and non-hysterical case for why he and Ashya’s mother took the unusual step of removing him from hospital care. They used the Internet to research alternatives and the one they chose was not one based on crystals or cabbage soup but on conventional radiotherapy, which goes against what would have been the media’s preferred narrative: that the Kings were complementary medicine nutters.

That they are Jehovah’s Witnesses – a breakaway millenarian Christian branch that, by strict doctrine, refuses blood transfusion, or so I’ve read – was seized upon initially before the facts were known. It was during this cloudy period of speculation and kneejerk conclusion-jumping – a vacuum into which rolling 24-hours expands to fill – that the facts got away from us. But it seemed to me that reason was to some extent restored and hysteria averted by the first YouTube video.

Naveed subsequently posted this, to reassure those who would condemn his family’s decision that they did not make it lightly or without investing time, effort and money into ensuring Ashya’s normal feeding routine would not be interrupted.

In Madrid, which is 322 miles away from Málaga, where Ashya remains under armed police guard in a foreign hospital, Judge Ismeal Moreno ordered that his parents be held in custody for up to 72 hours while he studied medical reports and documents from the couple’s defence lawyer. Those who insist on blaming the parents will experience a weird sort of melancholic schadenfreude here – if they hadn’t “snatched” Ashya, they’d have been at his bedside in Southampton, instead of staring at the walls of separate cells in Madrid.

Again, although we can only know what we know, the family’s lawyer gave a statement denying that Ashya’s life had been at risk, and that he had been admitted to the hospital in Málaga “in a perfect state of health”. (Ashya’s brother Daniel, 23, was with him in hospital – thank heavens for small mercies in a case where very little has been shown, in my emotionally crazed and ill-informed opinion.)

There is still a chance that common sense will prevail and the family will be reunited after days of stress that none of them asked for. There was no “snatching”, there was “abandonment” (quite the opposite) and there has been no “neglect”, the flimsy basis of the arrest warrant and the threat of extradition. I asked aloud on Twitter when David Cameron would step in: he’s quick to get on the phone to Obama when the US needs our “military prowess” – why not a quick call to Spanish Prime Minister Mariano Rajoy? Nick Clegg has weighed in today, coincidentally after the Daily Mail made it a campaigning issue, although I fear one needs political and/or moral weight to make “weighing in” count. Cleggs boasts neither.

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I hold no torch for the Mail‘s dirty tricks and grubby Victorian hypocrisy, but when it gets involved, politicians tend to be roused from their slumber. I’m no expert on the law, but isn’t extradition – an outcome that is on the table – basically about co-operation of governments? Though the Kings have refused extradition, surely some co-operation could resolve the matter before – and let’s not be coy – things deteriorate?

Unless Brett King is lying through his teeth, he was “threatened” with a “protection order” by the boy’s oncologist if he continued to push for the proton beam option and thus defy the child’s doctor – which would have meant (ironically) that he and Ashya’s mother would have been denied access to their son’s ward. That prospect seems to have driven them to act. They’d contacted the Prague clinic, but when the clinic contacted Southampton for the requisite X-rays and paperwork, the request was ignored. (Unless, again, Mr King is lying, or dressing up the facts. The fence-sitters will cling to this grey area until the story has been the subject of an independent review, I guess.)

Is it so wrong to air a gut reaction to a news story as it unfolds? I felt so sick about how quickly a child’s parents can be painted as neglectful, irresponsible criminals in a supposedly free society. Even if the hospital felt it was acting in the best interests of Ashya King, did it really have to call in Hampshire police so soon after discovering he had been removed? The first “breaking” media reports were of a “missing boy” who had been “snatched”. He was not missing. He had not been snatched. Assistant chief constable Chris Shead said in the police’s first statement on Friday: “It is vital that we find Ashya today. His health will deteriorate rapidly. Ashya is in a wheelchair and is fed through a tube. The feeding system is battery operated and that battery will run out today.” Clearly, at this stage, the police had no idea how well equipped the King family was, but no wonder the world acted with alarm.

I can totally understand Hampshire’s “damned if we did, damned if we didn’t” defence, but what I personally regard as a heavy-handed, panic-button reaction did not help matters, or contribute to the boy’s health. A European arrest warrant? Could they not have called the family to ascertain how much danger Ashya was in?

I’m not a parent. I will never be in the Kings’ position, thank God. But this didn’t stop me from feeling for them. Commentators have been saying, “It’s what any parent would do if they felt it was the best for their child.” I suspect the unconditional love for a son or daughter would trump all nuanced options, but I think the Kings should be applauded for taking such careful preparation before removing Ashya from care. (Naveed said that their mother was “by Ashya’s side for the whole month that he was in hospital.”)

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I don’t pretend to have all the answers. But since we all hope that Ashya’s health will improve, by whichever treatment his guardians decree and pay for, at least there is some common ground. Without the Internet (and some of us can remember a prehistoric time before it), patients were in thrall to doctors for advice, and took it, without question. The dissemination of information, while wildly unpoliced across a once-super highway full of potholes, means access for all, even we plebs who do not have the luxury of a medical degree.

But a little knowledge can be a dangerous thing, and that works in both directions.

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8 thoughts on “A second opinion

  1. I wasn’t one of the people who engaged with you on Twitter on this one, Andrew, but I suspect you’d have called me a fence-sitter if I had. Perhaps it comes with being a lawyer – we like to know the full story before weighing in. (I’m also a parent, for what that’s worth, and I thank the Lord I only believe in some of the time that I haven’t had to face anything like this.)

    But from the hospital’s point of view – and I accept up front that we don’t know all the facts yet – it could well have been faced with a situation in which it has disagreed with a family about the most appropriate treatment for a seriously ill five-year-old boy. The boy then disappears, apparently taken (I agree, words like “snatched” don’t help) by the family. The hospital doesn’t know where he is, or that the family has (apparently) made extensive provision for the wellbeing of the boy. They haven’t seen any YouTube videos. It’s defensible for hospital staff to assume that the life of the boy is in danger. What then? Shrug their shoulders and hope it turns out all right?

    Was what happened heavy-handed? Perhaps it was, and the CPS appears to have conceded that. But was it understandable, given the situation and the timescales? That, in my view, takes us into the grey area you’re willing to dismiss.

    • Which is why I would make a terrible lawyer. But a great shouter at the TV screen when the news is on. (I respect your view, of course. I was dismayed by the amount of times I felt I had to point fence-sitters at the first YouTube response on Twitter – evidence, if you will, for the defence – as it had really coloured my judgement of the case.) I still don’t know why – and nor do any of us, fence-sitter or otherwise – the hospital didn’t contact the family before calling in the police. They seemed surprised by the media storm in the first video, when they asked for the search to be “called off”, so can they really have been ignoring calls from the hospital, and then from the police? I’m sure more facts will come out. I may be proved wrong. But I’m not a lawyer, thankfully for everybody else(!), and I wanted to enshrine my thoughts at this time.

  2. Andrew I was somebody who briefly engaged you on Twitter. My main concern was the hospital staff being portrayed as the bad guys, it was suggested that the hospitals sole interest was finding Ashya to prevent him from receiving treatment when this clearly wasn’t the case.
    My understanding of the story was based on this BBC item from the day after his disappearance. http://www.bbc.co.uk/news/uk-england-28978655 it contains the hospitals initial statement.

    As you can read the primary concern of the hospital was to obtain information about Ashya’s condition and treatment. The worry over the battery pack appears a genuine one if they are travelling and away from a mains electric supply. The hospital also say they did try to contact the family but were unsuccessful. I do not doubt what the father said in the video about his sons care but I also have no reason to doubt the hospitals version of events either. I suspect this is a serious breakdown in communication between all parties in a very emotional situation.
    The hospital has a very difficult job balancing the wishes of parents and children with its own duty of care.
    Regarding the police they can only go on the information they have and if they have little to go on and the hospital says the child needs to be found immediately then they have every right to act the way they did better to be proactive than cautious. I suspect the current climate surrounding crimes against children also coloured their thinking.

    On everything else I agree with what you and President Bartlet say.

    However as an NHS worker I could see where the narrative was going in this story (not necessarily your narrative) an attempt to portray the hospital as being heavy-handed, full of heartless bureaucrat managers telling parents what to do. It’s exactly the sort of narrative the right wing press enjoy, encouraging people to distrust the NHS and making it more easy to privatise. But this is not the case here.

    • I, too, am wary of falling in the Tories’ trap of criticising the NHS – an institution that I hold as dear as I hold the BBC and whose privatisation goes against every bone in my body. My narrative was always with the parents. I am not a kneejerk critic of the police, either (I have relatives in the force), but intuitively felt that the arrest warrant was wrong. A lot of people with better knowledge of the law seem to agree. If you’re right and “the current climate” affected the judgement of the police, then that’s a sad reflection of the ugly society we live in – that parents removing their own child from care was linked with abuse. (You may be wrong, of course, but it’s credible.)

      There are lots of people doing difficult jobs here. A lot more difficult than my job. I respect your viewpoint. What bothered me about the discourse I encountered on Twitter (which is a fallible medium for clarity in any case) was that many people seemed intent on attacking the parents, and not the institutions. It’s the parents, the family and the boy who have suffered the most in this nightmarish story. They never deserved all the assumptions made about them.

      • I wholeheartedly agree, Twitter is built for brevity not nuance with many sprinting to be the first to post an opinion without knowing the full facts.

        I must stress that I am not suggesting the police thought Ashya was being abused by his parents or any abuse took place. My meaning was that the police have been criticised for not taking crimes against children seriously. This time it appears they’ve acted a little too seriously.

  3. I always find it interesting how professionals are always accused of over-reacting or being heavy handed after the child has been found safe.

    Usually by people who have no concept of just how nasty life can be to five year olds.

    I’d much rather have professionals who worried enough about the safety of a child to do all this, as opposed to waiting around for two days to see if a video might appear on YouTube.

  4. Hi Andrew. I started reading your blog a few months ago, but I followed you on the Guardian for quite a while.

    I am definitely not a fence sitter in this case for me the the right place for the Kings is the jail.
    I completely disagree with you and I despise the press that is only able to follow the public sentiment and not be firm in what they stand for, including the guardian, all of them turned 360 degrees as soon as the popular feeling changed.

    I am very surprised that so many people just think it is right to get a kid out of a hospital bed without telling anybody and just disappear. They sparked a well justified search and wasted time and money.

    I think this case is a clear example of the breakdown in society that we are experiencing, an experienced doctor should have more weight than something read on the internet.
    Do we remember the Vaccine-Autism myth and the emergency vaccinations of last year? Is it not in the same philosophy?

    Everybody that thinks the Kings acted properly believes in a completely anarchic society, I may be a very old school socialist but I believe in strong state structures, be it schools, hospitals etc etc, they reinforce the feeling of living in an unified society and avoid the formation of so many different ghettos.

    • Then we shall agree to disagree on pretty much every point you’ve made. And as a socialist I, too, believe in a strong state. But not to the point that individual freedoms are taken away. That’s totalitarianism. If there’s a breakdown in society, as you put it, it’s the way the NHS and other essential services are being either privatised by stealth or just privatised in full view, leaving individuals at the mercy of the free market. When two parents are criminalised, and locked up, for choosing to remove their child from a hospital, that’s a police state from where I’m sitting.

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