IT CANNOT happen very often that, in an agonising saga that concerns a desperately sick little child, the Catholic bishops of the boy’s home city and country line up on one side of an argument, with the pope, apparently, on the other, along with two other European governments.

Nor does it often occur that a British judge, adjudicating on such a delicate and painful case, becomes so exasperated with the self-appointed advocates of the child that he calls one of them “fanatical and deluded.”   

Yet these were among the many bizarre and distressing features of the story of Alfie Evans, a little boy of 23 months who died early on April 28th in a hospital in his native Liverpool.

Alfie was suffering from an undiagnosed brain disorder and was described by his doctors as being in a semi-vegetative state. The medical team at the Alder Hey hospital were of the firm opinion that keeping him alive on a ventilator was not “in his best interest” and that further treatment would be pointless and possibly cruel. His life-support was switched off on April 23rd after a lengthy and complex legal battle. 

Alfie’s parents, Thomas Evans and Kate James, had been told that an alternative course of action was possible. They have been surrounded by a well-connected network of advisers, including an American Catholic missionary, Christine Boesamle, who says she moved to Liverpool to support the family in September. This network arranged for an air ambulance to stand ready to fly the toddler to a Vatican-owned hospital in Italy which had expressed keenness to take care of the child.         

Things came to a head on April 23rd as the Italian government granted Alfie citizenship and Italian officials threatened to hold the authorities in Britain responsible for the homicide of an Italian citizen. Senior officials of the Polish government also called for the boy’s release from hospital. 

In a final round of court action, the boy’s father was represented by the Christian Legal Centre (CLC), a lobby group which opposes abortion and gay rights, and the judge had harsh words for the group’s representative, a Russian-born writer called Pavel Stroilov, accusing him of drafting a witness statement that was “full of vituperation and bile”. The CLC retorted that the judge’s view of their organisation and its role was “prejudicial and inflammatory”.

One indication of the powerful connections of the hospital’s critics was the personal interest that Pope Francis took in the saga. He met Thomas Evans on April 18th and was photographed blessing him. One papal tweet, issued two weeks earlier, implied some sensitivity to the nuances of the case: it voiced the hope that “everything may be done in order to continue compassionately accompanying little Alfie Evans.” But another, issued on April 23rd, seemed ill-advised: “I renew my appeal that the suffering of his parents may be heard and their desire to seek new forms of treatment may be granted.” 

In all the tortuous legal hearings connected with the case, the one thing that was universally agreed by medical experts with knowledge of Alfie was that no “new forms of treatment” offered any hope for the child. 

In any case the Catholic bishops who were closest to the story, those of England and Wales, insisted that the hospital was doing the right things. On April 18th they issued a statement which praised the “professionalism and care for severely ill children” at the Alder Hey hospital and said this excellence should be “recognised and affirmed”. 

Then Archbishop Malcolm McMahon, the Catholic hierarch of Liverpool, flew to Rome and put to the pope his view that, while Italian concern for the little boy was commendable, the medical and legal services of Britain deserved to be respected.

Agonisingly hard moral dilemmas can arise over terminal illness, and it is not surprising that doctors and families sometimes pull in different directions. But in medical terms this was not one of the most difficult cases. The boy’s parents appear to have been given some very misleading advice. It is a matter of regret that at certain points, the pope was apparently swayed by it, too.