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Medical Treatment of Children with Cerebral Palsy: Who Decides?


In the recent case of TM [1] precisely this situation occurred.

In brief summary, TM was a 7 year old girl with cerebral palsy and associated complications. One of those complications was not only that she could not feed herself, but also that she was not getting enough nutrition.

Initially TM was being fed via a tube inserted through the nose and down into her stomach. That is a procedure which has to be repeated, causing distress and carries risks of pneumonia if fluids get into the lungs.

An initial operation was therefore carried out to provide direct access to TM’s stomach via a tube, and another tube was inserted into TM’s neck to also provide her with necessary nutrition.

Unfortunately the tube in the neck caused an infection, and the tube into the stomach needed to be re-sited to provide better nutrition to TM.


For reasons that are not entirely clear, the relationship between the hospital and in particular TM’s mother broke down, such that TM’s mother would not consent to further treatment for her daughter and wanted a specific doctor excluded from her daughter’s care.

The Court therefore had to decide whether or not the treatment should be carried out, and if so whether specific doctors could be excluded from ongoing care.


The Court decided that the treatment should be carried out, because it was in TM’s best interests to do that because there were considerable advantages to her and very few disadvantages of the treatment.

The Court also decided that given it was acceptable for TM to be treated at Great Ormond Street Hospital in London then, unless there was a very clear and good reason for them to interfere, they would not say who could and could not carry out medical treatment at that hospital.


We act in a considerable number of cases for children with cerebral palsy which is as a result of clinical negligence at the time of their birth.

This case illustrates the ongoing stresses and strains the disabilities associated with cerebral palsy place upon our clients and their families, and how their need for legal assistance and compensation goes far beyond the initial act of negligence.

Because of the complexities of the law and the medicine in respect of severely disabled children, it is vital that if there are concerns that a child may have been injured as a result of negligence at the time of their birth that you seek legal advice from a suitably specialised firm, such as the Clinical Negligence Team, to ensure the treatment is fully investigated and the best experts are instructed to ensure the best outcome to the case. If you have any concerns please do not hesitate to contact me or one of my colleagues.

[1] (2013) EWHC 4103 (Fam)

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