An ordinary meeting of the Society was held at the Ampfield Golf Club on Wednesday 2nd October 2019. The President was in the chair. The meeting started with a minutes silence in the memory of Dr Pamela Ashurst and Dr John Wales. The President then introduced the speaker Dr Iain Macintosh, Director of the Paediatric Intensive Care Unit in Southampton, who spoke to the title “Difficult Decisions in Paediatrics”. He started by showing extracts from a film on Channel 4 that followed 8 families that had a child with a life limiting illness. We saw the ethics committee discussing with one family the choice they had to make between their child, which was on life support, suffering for a longer time with intensive care or being allowed to die sooner. As the Mail-on-line put it next day ‘the devastating moment when parents decided turn off life support”. His team then analysed the social media reaction. They found that in general people were supportive. There were some comments about wasting clinician’s time and critical remarks about the financial cost. The team also searched a number of other headings such as ‘Parental choice’ ‘Religious Objections’, ‘Benefits of Tracheostomy’, ‘Critical decisions by the bedside that the child can hear’ and ‘Alfie Evans’. In the latter case they found Facebook groups that excluded anyone that had an opposing view to theirs, to the extent of an extreme like-mindedness. In this type of group there was evidence-free blame attribution. They found the public in general were not judgemental and expressed surprise at the lengths the hospital go to to help parents make good and fair decisions; that there was trust in the trustworthiness of clinicians. For Alfie Evans the reaction was exceptional with the help of the press casting the medics as villains. Dr Macintosh said that of course these decisions won’t go away. It is not about the decision but about the process. It has to be a story-telling type process and we need to share this more widely. There needs to be more GP involvement.The cost didn’t seem to be questioned: it is in fact about £250,000 a year to maintain a child on life support. The media do not help by highlighting only heroic results thus creating unrealistic expectations. Crowdfunding for treatment abroad, especially the USA where there is always someone who will take on a case, is a common consequence and unfortunately the press rarely report the outcomes of those cases and the child is forgotten.

The President thanked the speaker for his interesting talk. The meeting was closed at 10.00pm.