1 HIS HONOUR: This is an application by the Director General of the Department of Community Services for orders which will have the effect of permitting doctors having the medical care of a very young child, who was born on 2 December 2004, to provide treatment designed to prevent a worsening of certain conditions with which he was born.
2 This is a very difficult case since the primary problem faced by the child may be described as, in lay terms, significant brain dysfunction. The diagnoses are as follows -
(1) Prematurity (35 weeks gestation)
(2) Intra uterine growth retardation
(3) Ventriculomegaly (hydrocephalus) with in utero intraventricular haemorrhage
(4) Thrombocytopenia secondary to PLA3 alloimmunization.
3 In lay terms he suffered bleeding within the brain before birth and continues to suffer from water on the brain. Of immediate importance is the condition of thrombocytopenia, or lack of thrombocytes, also known as platelets. These are important components of blood that reduce bleeding and haemorrhage and the risk of bleeding and haemorrhage. The thrombocytopenia suffered by the child arose from a process in which in utero antibodies in the mother's blood attack the child's platelets because she and the child have different blood groups. Whatever the explanation, the child needs infusions of platelets, by way of blood transfusion, in order to keep them at an appropriate high level.
4 There can be no doubt that, even with optimum treatment, the child's condition is serious and his prospects for full and happy life must be regarded as questionable. It is probable that he will suffer at least some degree of disability. It cannot now be assessed. It may be mild, but it may well be severe or profound.
5 The child's parents, who have been placed by this situation in a very difficult position with which it is impossible not to sympathize, feel that it is in their child's best interests that there be no intervention as proposed and that (I would say nature but) they say God's will should be allowed to have its way. The child's father has addressed the Court and said -
"I must say that no one loves our son more than we do."
"That is the first child. To our understanding and our belief, we have got a big problem. We have a big problem because this problem, it didn't happen after birth, it happened a long time before birth, at least three months. So there is brain damage. The optical nerve had been affected. His motor functions, such as walking, had been affected and no one knows what it is. So I wouldn't like to see him live and suffer, suffering to live in this sort of disability, suffering. He can't walk and he can't talk and he can't see in all his life, suffering. He doesn't have to be in pain and suffer.
To me before him and after him I have nothing. Before him I had nothing and after him I am going to have nothing. It's all in God's hand, so we rather see him rest in peace instead of, you know, going through all this, suddenly go down, blood transfusion because it's just, you see difficult for me. I am not a doctor. I am not a medical man, but I have seen this with my eyes the results and x-rays. He looks very bad. He doesn't look normal to us.
So when it comes to brain - if it's heart, kidney, any organ, that's fine, I am happy to do anything, but when it comes to brain, there are hundreds of millions of cells that had been damaged. I don't think there is going to be science, no matter what you can do, I don't think we can revive these cells. The damage is in the brain and the damage has been done. So what can we do now? According to what they say, to stop more damage. They said to me on many occasions that if they did not do this more damage will happen.
In the meantime one Polish doctor, Dr Colin - I am not sure about his second or third name - has said that his count, his blood count, red cells are so low that it was 15,000 when he was born, if they did not do blood transfusion or blood test transfusion it would keep on going down and down until it reaches below 5, in this case he will die because it would affect his heart and functions of the body because his heart will stop, his kidney will stop.
It's not we are now asking for diminishing rescue, but we are asking that he goes in peace. That's our object when he was first born on 2 December last year. That is for his own sake, not for our sake as parents, or not the Government's sake as part of the Government's responsibilities for the community. It's only for his own sake that this boy will suffer. If he can't talk and walk, how can we feed him, and how can he go to the toilet if he can't see, you know. You do not know what is going on. That is our view about it. There is nothing more than love."
"I must tell your Honour that the things that I would like to say. To my belief, and my belief as a parent, "Mathew" has lived since he was born without these procedures which is mainly the blood transfusions. We are quite sure we didn't mean to take that from him. It may be, I apologize. It's all this stuff and issues that have been canvassed.
There is another issue. I am seeking medical records from both Nepean and Randwick Children Hospital because I am seeking independent medical advice and I would like to have a look at all the records to see what they think. It is a matter of trying to see what it is."