Pavel Stroilov, consultant to the Christian Legal Centre, comments on why we are helping the Abbasis seek justice for Zainab.
A few years ago, the Christian Legal Centre and I personally came under fire for the role we played in the case of Alfie Evans. We supported his parents in their last-ditch legal battle – and a public campaign – to rescue little Alfie from Alder Hey Children’s Hospital in Liverpool, where his life support was about to be switched off, and take him to an Italian hospital which was willing to keep him alive. While our involvement was brief – only three weeks or so – that was the most dramatic stage of that dramatic case. In addition to the flurry of applications relentlessly pursued through the High Court, the Court of Appeal, the Supreme Court, and the European Court of Human Rights, it was also on our watch that foreign ambassadors began raising this case with the British government, the Pope received Alfie’s father and publicly supported him, and hundreds of protesters took to the streets of Liverpool day after day. By the time of Alfie’s death on 28 April 2017, the case became a global controversy, and Alfie became a household name across the world.
Our contribution to achieving all that was much exaggerated at the time – not by way of flattery, but as an accusation. We were accused of hijacking a private tragedy and weaponising it to promote pro-life ideology; of giving false hopes to the grief-stricken family and manipulating them for our reactionary purposes. We were accused of an unfair vilification of the doctors and lawyers who only had Alfie’s best interests in heart, and were full of compassion for his family. It was argued that Alfie’s parents were not doctors, and the only decent course for us was to advise them to trust the doctors. Above all, we were supposed to have ruined the two things which are (it was said) most precious at the time of death: privacy and dignity.
Well, the video of a father arrested by the bedside of his dying daughter shows what happened in a similar case, to people the Pope and others have never heard about, without the glare of international media, and without protesters outside the hospital. It shows you what privacy and dignity really look like if your child is dying in an NHS hospital in accordance with their own rules.
Behind the scenes
The compassionate doctors concluded that it was in the best interests of a six-year-old girl, Zainab Abbasi, to switch off her life support. Her father, who happened to be a respiratory consultant himself, had too many questions to ask and too many arguments to make about that. The compassionate doctors called the compassionate police, who dragged him away from his daughter’s death-bed, fell him on the floor, handcuffed him, tied him to one of those medical trolleys, and drove him away. All in his own best interests, presumably. Accidentally, they gave him a heart attack along the way, but would not let him reach his pocket for a medicine which might have prevented it.
Their justification? “The staff has some concerns about your behaviour.”
What concerns? I suppose the fairest way to set them out is by quoting how the Hospital itself put them on the record in contemporaneous letters they served on Dr Abbasi. Here is the full list:
- “the medical and nursing staff must be allowed to perform their roles without being threatened, including comments in relation to nursing and medical regulatory bodies.” (7 August 2019)
- “medical equipment on the Paediatric Intensive Care Unit should be adjusted only by nursing and medical staff, even if you are very familiar with the operation of that equipment.” (7 August 2019)
- “there has been another incident on the night of Thursday 15th August in which staff felt threatened and intimidated by you.” (16 August 2019)
- “you entered the unit [where your daughter was kept on life support] without permission” (19 August 2019)
- “Confrontation – either through inappropriate challenging language, aggressive behaviour, raised voices, or inappropriate body language will not be tolerated.” (23 August 2019)
This is all they had to say at the time. They never attempted to substantiate those generalised statements with any particulars, which calls their credibility into question. But even taken at their face value, those statements do not begin to justify what you see happening in the video.
Secrecy and distrust
Alfie’s father, Tom Evans, was treated rather roughly by the authorities in his time. His relentless campaign to save his son annoyed them no less than Dr Abbasi’s medical arguments and “inappropriate body language.” And yet, I cannot imagine anything like this happening to Tom – because, and only because, that would have been all over the world’s front pages the following morning.
Most cases of this nature are shrouded in secrecy; and even on rare occasions when a parent like Tom Evans succeeds in making the world listen and sympathise, we still tend to be sceptical about their testimonies. After all, death is inevitable. It is natural that families find it hard to accept an imminent death of a loved one, and sometimes – unfairly but understandably – tend to blame the doctors who are doing their best. It is only fair to disbelieve any such accusations until and unless they are proven to the hilt. Doctors need that public trust, and cannot do their duty without it. All this must be acknowledged.
On the other hand, however, whenever a large category of people is given a high level of trust, sinful human nature makes it inevitable that some of them will abuse it. We have to trust, and we also have to be vigilant. This is not always an easy balance to strike.
Many of those who have had the unfortunate experience of being the ‘next of kin’ of a dying patient have sensed the disturbing pro-death bias, and pressure, from the NHS. Even then, however, most give them the benefit of the doubt – especially after the patient has died and there is nothing to be gained from a further confrontation. Too few are confident enough even to tell their stories. Fewer still are being believed by the rest of us.
Why did the extremes meet?
Not many parents who lost their children will have had quite the same experience as either Tom Evans or Rashid Abbasi. In more sense than one, those two cases are at different extremes. A comparative analysis can tell you a lot about the unknown cases in the middle, and the system as a whole.
Tom Evans left school at the age of 16, worked as a plasterer, and was only 21 when a cohort of top clinicians unanimously told him that his son must die. He chose to defend Alfie’s life by making his case as public as he could – which was the only way, at least in his position. He was then forced into that extraordinary legal trial where, in full view of the whole world, he argued about medicine with the country’s top medics and about law with the country’s top lawyers. He made an admirable superhuman effort, earning the respect of his opponents. Still, he lost in the end.
By contrast, Rashid Abbasi is himself at the top of the medical table of ranks; and happens to be an expert in that very area of medicine which his daughter’s life depended upon. He did not just hope, but knew, what Zainab’s chances of survival were, for how long, and what treatment was needed. There was no epic desperation, no forlorn hopes – Dr Abbasi’s argument was confidently realistic and rational throughout. He tried to talk to the treating clinicians as his fellow medical experts, asking questions and making arguments which the uninitiated would find hard even to follow.
The first time that happened, in January 2016, he successfully insisted on giving his daughter artificial ventilation and active treatment. Contrary to the Hospital’s predictions, that gave Zainab another four years to live.
The second time, in January 2018, he again succeeded in getting active treatment and saving her life. However, he also made some powerful enemies for himself, and then had to defend himself in a long and painful investigation by the police and social services (which completely exonerated him in the end). This is a different long story, to be told at another time.
The third time, Dr Abbasi was required to attempt to reason with his colleagues to save his daughter in August 2019. Their answer can be seen in the video.
Given the very different starting points for Alife’s case and Zainab’s case, it is all the more remarkable that they ended in the same way. It is not just that both children have died. It is also the fact that, whatever form the parents’ opposition to the child’s death takes, they soon find themselves in the presence of the police. A horde of respectful but firm officers occupied the hospital round the clock to prevent all attempts to smuggle oxygen in while Alfie was dying. A smaller but more brutal squad was called in to neutralise Dr Abbasi. But in both cases, the British state resolved a disagreement of this sort by force; and resolved it against the parents. In both cases, the police was there to enforce death.
Between the extremes of those two cases is the silent majority of family tragedies we know very little about. When doctors give up on trying to save a patient – child or adult – most families have neither the expertise of Dr Abbasi to debunk their medical opinions, nor the dashing bravery and relentless determination of Tom Evans to make the dispute known and cared about by the whole world. A typical family can do no more than press some common sense questions on the doctors, hear their answers, and leave it at that; or at most, ask for a second opinion (from someone nominated by the same hospital). Only the most stubborn ones end up in court – where the case is immediately protected from public scrutiny by a minefield of reporting restrictions, and then a death sentence is passed.
Truth will out
It has taken a long time for the truth about that system to trickle out. The scandal of Liverpool Care Pathway, the relaxation of the courts’ secrecy by Sir James Munby, the cases of Charlie Gard, Isaiah Haastrup, Alfie Evans, Tafida Raqueeb, and most recently M.S.P., have gradually aroused suspicions that something sinister is going on in those intensive care wards.
Ever since the Christian Legal Centre and I were officially pilloried as bulls in the china shop of Alfie’s case, we saw a growing inflow of distressed families telling disturbing stories, and asking for our help. For some mysterious reason, unlike those who worship the NHS from afar, people who live those tragedies are not deterred by our reputation as extremists.
Dr Abbasi’s is the latest such family. Alas, it is now too late for us to try and help little Zainab. However, her parents have carefully documented the story of her death and are determined to tell it to the world. Moreover, they insist that it should be rigorously, sceptically investigated at a public trial before an independent and impartial tribunal established by law. Not to vindicate themselves, nor to take revenge on those who treated them so badly – but because they believe, as we do, that this may help other families to resist this ruthless machine. There are other Alfies and other Zainabs out there, unknown and helpless, whose life is under threat from this cruel bureaucracy. The only way we can help is to expose the truth about its workings.
You can watch the full video of Dr Abbasi’s arrest below: