Judge rules unborn baby can be lawfully treated for HIV without mother's consent

A judge has ruled that an unborn baby, whose mother has HIV, could lawfully be given treatment for the infection - even if his parents objected.

Doctors at Kettering General Hospital started litigation over fears the mother might not consent to her child receiving anti-retroviral medication.

A High Court judge ruled that doctors could lawfully provide treatment, aimed at combating HIV, to the boy within four hours of birth.

Mr Justice Hayden made the declaration after considering evidence at an online family court hearing in London on January 23, but embargoed reporting.

The judge has now outlined detail of the case in a ruling published online - and said the birth went well.

He said a court order relating to an unborn child is "rare" and described the declaration he made as "exceptional".

The woman was unaware of the litigation and not at the hearing.

A senior barrister, appointed by the judge to give him advice, raised concerns relating to the woman's situation.

The judge, based in the Family Division of the High Court in London, said mother and child cannot be identified in media reports of the case.

He embargoed reporting after lawyers raised concerns the woman could be recognised through details of the case even if she was not named.

Mr Justice Hayden said he wanted to consider the issues around reporting before making details of the case public.

Kettering General Hospital NHS Foundation Trust in Northamptonshire had begun litigation and asked him for a ruling on treatment.

North Northamptonshire Council has welfare responsibilities for the child and was also involved.

The judge said the little boy is "doing well".

He said the woman complied with "the anti-retroviral medication immediately prior" to a Caesarean.

The woman and the baby's father were "expressing clear consent" to the boy's treatment regime, the judge added.

"I hope that when they read this judgment, they will understand why the court has taken the course it has," Mr Justice Hayden said.

"I should also like to extend my congratulations to them on the birth of their son."

Mr Justice Hayden said the trust's application was "intended to secure the administration of anti-retroviral medication" to the baby "immediately upon birth and to continue for a period of 28 days".

Doctors said it was "critical" that treatment started within four hours of birth.

Lawyers representing the trust said the woman had refused to take medication and thought the anti-retroviral regime was not "good for her baby".

The judge said it was "important to understand" the "mechanism of transmission" of HIV infection from mother to child.

A doctor has told him that HIV was a viral infection which could be transmitted from a mother to a child during pregnancy.

He heard how it passed from the mother to the child through the blood flow via the umbilical cord and through the mixing of blood and genital fluids during birth.

He said the "focus" had to be on treatment geared to "reducing the risk of infection in the child".

Katie Gollop KC had been appointed to give advice, because the woman was not at the hearing.

Mr Justice Hayden said Miss Gollop had "robustly tested the ambit of the applicable law and the wider medical picture".

But he added: "The fact that the baby may be able to live with HIV does not mean that he should.

"It is wholly contrary to his best interests.

"The doctors and medical team are entirely right to identify the immediate medical treatment as an imperative which establishes a secure basis for what remains an exceptional declaration."

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