Dance & Anor v Barts Health NHS Trust & Anor (Re Archie Battersbee): Upholding Best Interests under the Children Act 1989 and the Scope of UNCRPD in UK Domestic Law

Introduction

The case of Dance & Anor v Barts Health NHS Trust & Anor (Re Archie Battersbee) ([2022] EWCA Civ 1106) centers around Archie Battersbee, a 12-year-old boy who has been in a deep coma since April 7, 2022. The legal proceedings, held in the Court of Appeal (Civil Division) of England and Wales, primarily focus on determining what constitutes Archie's best interests under the Children Act 1989, Section 1. The pivotal question revolves around whether it is in Archie's best interest to continue or withdraw life-sustaining treatment, juxtaposed with the parents' appeal to international human rights frameworks, notably the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD).

Summary of the Judgment

The Court of Appeal, comprising President FD, Lady Justice King, and Lord Justice Peter Jackson, refused the parents' application for permission to appeal against the High Court's decision, which deemed it not in Archie's best interest to continue life-sustaining treatment. The parents sought to invoke Articles 10 and 12 of the UNCRPD, arguing that their rights and Archie's rights were being violated. Despite their attempts to seek interim measures through the UNCRPD and references to previous cases like Charlie Gard, the Court of Appeal upheld the decision to withdraw life-sustaining treatment. The Supreme Court similarly refused permission to appeal, reinforcing the stance that domestic law, particularly the Children Act 1989 and the European Convention on Human Rights (ECHR), take precedence over non-incorporated international treaties like the UNCRPD.

Analysis

Precedents Cited

The Judgment references several key legal precedents that influenced the court's decision:

Mamatkulov v Turkey [2005]: The case was cited to highlight the limitations of international treaties that are not incorporated into domestic law. It underscored that the UK courts are not bound to enforce unincorporated international obligations.
Charlie Gard Case: Used as a comparative precedent where the Supreme Court granted a stay to allow an application to the European Court of Human Rights (ECtHR), but the current case differed as the application was made to the UNCRPD instead.
R (on the application of SC, CB and 8 children) v Secretary of State for Work and Pensions and others [2021] UKSC 615: Lord Reed's judgment clarified that unincorporated international treaties like the UNCRPD do not have legal force within the UK, distinguishing them from incorporated treaties like the ECHR via the Human Rights Act.

Legal Reasoning

The court's legal reasoning was rooted in the principle of paramount consideration of the child's welfare, as mandated by the Children Act 1989. The judgment emphasized that domestic law, particularly the ECHR, takes precedence over non-incorporated international treaties like the UNCRPD. The court determined that:

Best Interests of the Child: Archie's medical condition was deemed unstable, with no realistic prospect of recovery, making the continuation of life-sustaining treatment contrary to his best interests.
Jurisdiction and Applicability of UNCRPD: The UNCRPD, not being incorporated into UK law, does not bind the court's decision-making process. The court referenced the Supreme Court's stance in R (on the application of SC, CB and 8 children), reaffirming that unincorporated treaties cannot dictate domestic legal outcomes.
Discretion of the Court: The court maintained its discretion to determine the necessity of a stay, balancing the parents' rights with Archie's welfare without being compelled by international requests not recognized domestically.

Impact

This Judgment has significant implications for future cases involving the interplay between domestic law and international treaties:

Reaffirmation of Domestic Primacy: It reinforces the principle that only incorporated international treaties, like the ECHR under the Human Rights Act, influence UK court decisions.
Limitations on International Bodies: Parents and parties cannot leverage unincorporated international conventions to override established UK legal frameworks, ensuring domestic laws retain authority in critical welfare decisions.
Setting a Precedent for Medical Cases: The decision provides clarity on handling cases where life-sustaining treatment is contested, prioritizing the patient's best interests as defined by domestic statutes.

Complex Concepts Simplified

Best Interests Principle

This principle mandates that in all decisions concerning children, the paramount consideration must be the child’s welfare. It involves a holistic assessment of the child's needs, rights, and circumstances to determine what will most benefit them.

Incorporated vs. Unincorporated International Treaties

An incorporated treaty like the ECHR, when enacted into domestic law (e.g., via the Human Rights Act), has direct legal effect in UK courts. An unincorporated treaty, such as the UNCRPD in this context, does not automatically influence domestic law unless explicitly adopted by legislation.

Stay of Execution

A legal order to temporarily suspend the execution of a court judgment or order. In medical cases, it can delay the withdrawal of treatment pending further legal review or external intervention.

Conclusion

The Dance & Anor v Barts Health NHS Trust & Anor (Re Archie Battersbee) Judgment underscores the supremacy of domestic law, particularly the Children Act 1989 and the ECHR, in adjudicating cases involving the withdrawal of life-sustaining treatment. It clarifies that while international conventions like the UNCRPD may inform ethical considerations, they do not possess legal authority unless incorporated into domestic legislation. The court's steadfast adherence to the best interests of the child principle ensures that Archie's welfare remains the central focus, setting a clear boundary for future cases where international human rights bodies seek to influence domestic legal decisions. This case reinforces the judiciary's role in balancing parental rights, medical ethics, and statutory obligations to protect vulnerable individuals effectively.