Alfie Evans, 23 months old, had a rare degenerative brain condition and died the end of April, five days after he was taken off life support.  He was born on 9 May 2016, and was admitted to the Alder Hey Hospital in Liverpool, England when he was 7 months old, after suffering seizures.  His doctors were unable to diagnose a specific ailment, and his worsening condition resulted in Alfie living in a semi-vegetative state for more than a year.  The doctors concluded that the limits of treatment had been reached and were determined to take him off life support.  Alfie’s parents have fought this decision, taking it to British High Court, the Supreme Court and the European Court of Human Rights.  Finally, they lost in the British Court of Appeal, which upheld all previous rulings in Alfie’s case.  Thus all courts rejected the parent’s appeal and approved the withdrawal of care.  The courts also prohibited Alfie’s parents from seeking treatment elsewhere.  This final ruling occurred despite the following:

• A hospital run by the Roman Catholic Church in Rome invited Alfie’s family to take care of him there. Indeed, Pope Francis expressed his hope that the parents “May be heard and that their desire to seek new forms of treatment may be granted.’
• The Italian government granted Alfie citizenship, hoping to tip the scales in favor of his traveling to Rome, but the British courts denied this.
• The Polish government weighed in stating the “Alfie Evans must be saved. Perhaps all that is needed is some good will on the part of decision makers.”  In Krakow, Poland a shrine to Alfie was built with flowers, candles and teddy bears, with one message: “Don’t let judges decide his fate.”

But Alfie’s fate was determined by British law.  Dominic Wilkinson, professor of medical ethics at Oxford University, summarized the British decision in this matter: “Some people believe that the parents’ views are paramount in every case, or that life should be prolonged at all costs, but British law does not accept either of these views.  The law of the country is that the child’s best interests are paramount.”

How should we think about the Alfie Evans case?  The case of Alfie Evans and the earlier British case of Charlie Gard both illustrate the growing tendency in Western Civilization to arrogate power away from families and place such power in the hands of the state.  Columnist Ross Douthat characterizes such tendencies as the “coming world of post-familialism, the world bequeathed to us by sexual individualism and thinning family trees.”  Furthermore, columnist Megan McArdle argues that the Alfie Evans case exposes a danger, “the danger of letting the centuries-long progress of liberal individualism go too far in breaking open the family and assigning its functions to the state.  That it has done so is beyond dispute.”  She goes on by observing that “It was startling to watch so many people ask, essentially, why we should prefer the opinion of the woman who gave birth to Alfie, over that of distinguished experts, as to what was in the best interest of the child.  But the people asking this make a fundamental logical error:  They assume the experts know the answers to questions such as “What does ‘best’ mean?” and “What is the subjective experience of a child with Alfie’ Evans’s condition?”. . . Which is why we should err on the side of the parents, particularly when we are not talking about lifesaving treatments but about (or so the doctors insisted) modes of death.  The parents love the child best.”  She concludes that “After all, the irrational, overpowering love of parents for child is the only reason most of us are alive, despite having spent the first years of our life vomiting, soiling ourselves, and destroying everything we could reach.  If that love can see us to a healthy adulthood, it can probably see us to a decent death.  Disinterested management by experts will never substitute for the family tie, because it seems to be wired into us a deep level . . . Liberalism has won most of the battles it set for itself centuries ago.  Now it needs to win the peace—by learning to recognize its limits.”

What does a world of “post-familialism” look like?  Fundamentally, it is a world where the state denies parental rights.  Theologian Albert Mohler correctly observes that “One of the most important rights throughout human history is the right of parents to make decisions concerning their children’s welfare.  Almost every culture and civilization has honored this principle—formally and informally—as a basic human right and a necessary foundation for family flourishing.  Western countries often recognized parental rights as natural rights—rights that cannot be compromised by government interference.”  But in cases such as Alfie Evans and Charlie Gard, the state is re-defining parental rights.  Several points flow from this observation:

• Mohler quotes Sohrab Amari who delineates that “The medical complexities of the case, played up by the court and its defenders, serve to obscure a basic moral principle. No one is asking the UK National Health Service to expend extraordinary measures to keep Alfie alive.  All Alfie’ parents ask is to be allowed to seek treatment elsewhere, again at Italian expense, even if such treatment proves to be futile in the end.”
• As the state continues to subvert the natural rights of parents, we will witness many more cases similar to Charlie Gard and Alfie Evans.
• Mohler also discerns another implication of government subverting parental rights: “. . . perverse incentives are often at play.  Some of the government officials in the UK making the decision about Alife, and those like him, are the very persons trying to save money in the healthcare system.  Many of these individuals making these decisions are driven by legal and moral assumptions that are wildly at variance with the sanctity of life.  Furthermore, many of the people making these decisions may be operating from worldviews directly at odds with those of both patients and parents.”

The case of Alfie Evans illustrates a frightening trend in Western Civilization:  With the power of the state, we are denying human dignity and the sanctity of life for every human being.  Western Civilization is in effect progressively redefining medical ethics and legal authority over life decision-making.  Mohler writes:  “Those who want government to take even greater responsibility and authority in health care decisions promise that government will be wiser than the rest of us.  But any system that shifts authority for deciding what is in the ‘best interest of the child’ from parents to the state and its agents puts every child in danger.  Any system that eliminates the rights of patients, parents, and family members to make the most urgent decisions about medical care endangers every patient.”

In conclusion, permit me a few theological propositions that relate to the Alfie Evans case:

1. God has created three primary institutions through which He does His work—the family, the state and the church. Each institution has stewardship responsibilities before God.  The state is not to raise children, nor is the church to raise an army to defined the nation.  When the state takes over parental decisions and uses its power to coerce decision-making it deems “best,” we are entering the realm of ethical chaos.
2. Because humans are created in God’s image, that fact establishes the infinite worth, value and dignity of all life, regardless of the condition or health of that life. From God’s perspective, life is a continuum, beginning with conception and going on into eternity.  It is the stewardship responsibility of parents to nurture, care and provide for children.  This is not the responsibility of the state.  Parents determine what is “best” for their child, not the state or its agents.
3. The actions of the UK medical community and the UK courts evidence a lack of compassion and empathy, one of the ugly results of “disinterested management by experts.” A compassionate and caring society is one that identifies with and understands the love of parents for their child.  When other nations and/or religious groups offer to take care of the child without any expense to the UK or its National Health Service, it is inhuman and hideous to deny parents the right to care for their child.  When raw, bureaucratic decisions trump those of loving parents, we are indeed at the limits of the “liberal individualism” that has built the welfare state of Western Civilization.  It is a revolting development and one of the low points of a civilization ethically anchored in mid-air!  May God have mercy on us!

See the news reports on Alfie Evans by Richard Perez-Pena and Yonette Joseph in the New York Times (27 April and 29 April 2018); Ross Douthat in the New York Times (29 April 2018); Megan McArdle in the Washington Post (1 May 2018); and J. Albert Mohler Jr., “Life in the Balance in Liverpool—Alfie Evans is Not Alone,” at www.albertmohler.com.