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Alfie Evans and Libertarianism

General view of a message of support for Alfie Evans in Liverpool, England, April 23, 2018. (Lee Smith/Action Images via Reuters)

Michael Cannon of the Cato Institute purports to be suggesting that “conservatives have the Alfie Evans case all wrong,” but he seems to me to be concentrating on ancillary aspects of the argument that people on the right have been making about the case. It is certainly true that a lot of conservatives have seen the case as a warning about the dangers of socialized medicine, which is the point he mostly disputes. But the primary point that critics of the British authorities’ handling of the case have made is different: that the authorities should have allowed Evans’s parents to take him elsewhere for treatment, and not overridden their preference on the ground that the child was better off dead than continuing to survive in his severely disabled condition.

On these central matters, what Cannon says is this:

As hostile as libertarians are to government, even we believe government can legitimately order the withdrawal of life support, and prohibit parents from moving a child to obtain further treatment, when that treatment would fruitlessly prolong a child’s suffering – i.e., when further treatment would be akin to torture. In such cases, the government intervenes to protect the child’s rights. (British law frames the decision in terms of the “best interests” of the child, but it seems to me that language clouds the issue and thereby unnecessarily inflames passions.)

There is no objectively right place to draw the line between cases in which the government should and should not intervene. But I don’t know anyone who thinks it never should. If anyone does make that argument, they’re just wrong.

I think Cannon is making a big mistake here — a mistake similar to the ones that some Catholics made in the Evans case. The two general points from which he starts are valid. First, there are indeed imaginable circumstances in which a government could rightly block parents from seeing to it that their child received a particular course of treatment for a medical condition. If parents had found someone prepared to treat their small child’s cold by having him lie on hot coals, for example, their hypothesized sincerity would not be enough to stop a sensible government from intervening. Second, the circumstances under which such intervention is appropriate cannot be spelled out comprehensively. In principle there could be edge cases.

But the actual case was nothing like this. The courts didn’t allege that the parents were abusive, neglectful, or incompetent. They merely asserted that emotion had misled them, and that Alfie Evans’s life was of too low a quality to be desirable to prolong. The first judgment by the authorities should not have been enough to override the parents, and the second shouldn’t even be part of a case for an override. It should not be hard to recognize a presumption for parental authority and to see that nothing that could possibly justify overcoming it was present in the case; and to see further that the government’s view that continued life was of too low quality to be desirable can’t be a justification for such intervention. It should not be hard, especially, for a libertarian.

In the actual case, no evidence was presented that Alfie Evans was suffering or that the treatment his parents wanted would cause him to suffer (except in the sense that continued existence in a disabled state allegedly constituted an affront to the child’s dignity). The courts mentioned only speculation that he would suffer, speculation at odds with their simultaneous insistence that the deterioration of his brain had left him unable to feel pain.

Most libertarians would acknowledge that child abuse can justify removing children from parental custody and that defining the precise parameters of that principle is difficult. It does not follow that if the state seizes a child from his parents because he gets sent to time-out too often, it’s just a tricky judgment call and who’s to say who’s right?

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