Cardiff and Vale University Local Health Board v SR & Ors [2026] EWHC 348 (Fam)

The child at the centre of the matter was TR, who had been diagnosed with Leigh Syndrome – a fatal mitochondrial disorder which is progressive. Leigh Syndrome can lead to irreversible brain damage and dependence on a ventilator as well as a loss of cognitive awareness, and has no significant prospects of recovery.

The Cardiff and Vale University Local Health Board applied to the High Court seeking a declaration that it was both lawful and in the best interests of TR to stop an invasive form of ventilation, which was opposed by both parents.

Both parents gave evidence to the Court, with TR’s mother describing a cooperative relationship with the treating clinicians and her experiences with TR where she believed he was not suffering based on experiences with the child where they had shown signs of awareness and responsiveness. Her Muslim faith was also at the core of her opposition, believing withdrawing treatment would go against her beliefs and inflict spiritual distress and emotional trauma.

This was reinforced by TR’s father, who also opposed the application due to his Muslim faith while also questioning the certainty of the prognosis and expressing concern clinicians were focusing too heavily on future risks rather than the child’s present condition – accepting that while the condition was severe, TR had already outlived medical expectations.

The Court confirmed the legal principles which fed into matters of this nature are already well settled and adopted the framework which was proposed on behalf of the Health Board, also affirming that the Court has jurisdiction to make declarations relating to treatment where the child cannot decide for themselves and there is a disagreement between the parents and clinicians.

The core legal issue was whether the proposed course of action – in this case withdrawing treatment – would be in the best interests of the child after a holistic and objective review of the child’s welfare.

The case involved complex consideration of the law in terms of medical ethics and best interests as well as Human rights considerations. The London public law team worked through tens of thousands of pages of medical notes to ensure that the mothers case was presented to the Court in the highest degree.

The Court ultimately declared that it was not in the best interests of TR for life-sustaining treatment to continue – approving the withdrawal of the ventilation and the implementation of an updated palliative care plan.

In making this decision, the Court affirmed that the welfare of TR was to be considered above all else and the Court needed to objectively decide what treatment served TR’s interests and while there exists a presumption in favour of preserving life – this decision must be made balancing all evidence including parental views, religious beliefs, and medical considerations.

The Court accepted that continuing treatment for TR would be difficult given the significant physiological risks with ongoing ventilation as well as accepting medical evidence provided by experts which suggested that TR had suffered irreversible brain damage and was in the terminal phase of his illness with no prospects of recovery and that continuing the treatment would not halt or mitigate its progression.

However, it was also acknowledged by the Court that the devotion and love shown by TR’s parents, as well as the intersection of their objections against stopping treatment which included their impact on family life and the importance of their Islamic faith, could give way to experiences with TR that could be perceived to be a source of hope for recovery.

But upon weighing the competing factors, the Court decided the specific nature of TR’s condition was more significant than the continuation of the invasive treatment.

Thanks are given to all of mothers legal team for their hard work and compassion throughout what was a very sensitive matter.

To view the full judgment, click here.