Quebec hospital may remove child's breathing tube despite parents' objection: court

MONTREAL — A Montreal children’s hospital can permanently remove a breathing tube from a child who has been in a coma since June, despite his parents' objections, a Quebec Superior Court judge has ruled.

The Sainte-Justine hospital went to court after the five-year-old boy's parents refused to consent to the procedure unless the hospital planned to restore the tube if things went wrong.

The hospital argued that the child, identified only as "X" in the ruling, can breathe on his own and that the breathing tube is now causing more harm than good.

Justice Bernard Jolin wrote in his ruling Tuesday that the parents' objections to the procedure are not in the child's best interest and are based on their hope that God will miraculously bring him back to the state he was in before he fell into a swimming pool.

"It is true that extubating carries a risk of death for X, but in light of the evidence, this risk arises much more from his condition than the extubating itself," Jolin wrote.

The child has been in a coma since June 12 after he was found at the bottom of the family pool. He had been in the water for between 15 and 20 minutes.

He has been on a breathing tube since his admission to hospital, but doctors have recommended since June 16 that it be removed because "it is likely to cause serious, even fatal damage," the judge wrote.

The hospital argued that removing the tube could allow the child to return home and to receive physical therapy, but that delaying the removal will limit the chances of that happening.

Jolin found that the parents' opposition to the procedure is based on their religious faith and a lack of trust in the medical team — including the belief that the hospital wants to take him off the tube to save money.

The parents also believe they have seen an improvement in the child and that the mother believes he is "very aware of his surroundings," which the judge said "deviates from a proper perspective of reality."

"Some will appreciate the parents' unconditional love for their child and their relentless fight to keep him alive. Despite all the empathy it may feel, the court concludes that the parents' refusal to consent to the plan is not justified and is contrary to X's best interest," he wrote.

Evidence presented in court showed that the time the child spent under the water caused serious and irreversible brain damage.

The hospital said Thursday it will wait until the parents decide whether to appeal the decision before removing the tube. Patrick Martin-Ménard, a lawyer for the parents, said they are studying the decision and have not yet decided on an appeal.

"It's been very difficult to go all the way to the court, for a court decision about their child, when they would have been open to alternatives earlier on had there been a proper discussion and collaboration," he said in an interview Thursday. "But what we have seen, unfortunately, for a very long period of time, has been an attempt to impose a decision on the parents by Sainte-Justine."

He said the consequences of removing the tube remain unclear and that those consequences could require reintubation, which is not allowed under the court order.

This report by The Canadian Press was first published Nov. 3, 2022.

Jacob Serebrin, The Canadian Press