The Secret Barrister responds to an Ultra-Conservative American activist who despises government-run healthcare and wants to make Alfie Evans a symbol of the NHS failure.

[This piece was originally written in the format of a Twitter thread and has been minorly edited and corrected.] 

Update, 28 April: Little Alfie Evans died at Alder Hey children’s hospital in Liverpool in the early hours of Saturday morning. The article below was written and edited on 27 April.

Liz Wheeler is an Ultra-Conservative American activist who hosts her own show, Tipping Point on the Conservative One America News cable/internet channel. She believes that government-run healthcare is evil and that through the actions of judges and the police, the state has full control over people’s lives.


As an an educational exercise, the Secret Barrister has decided to explain how the law works in England and Wales and how it was applied in the case of the little Alfie Evans.

Start with the basics. Separation of powers:

  • Executive (Government)

  • Legislative (Parliament)

  • Judiciary (Courts)

All constitutionally separate.

Here is the judgment from the High Court in the case of Alfie Evans, from February 2018. You will note that the UK Government is not a party to proceedings. We know that because the name of the relevant Government minister (the Secretary of State for Health) does not feature in the document:

Boiling this down to simple concepts that anyone can understand, the legal dispute is between the doctors at the hospital and Alfie’s parents as to what is in Alfie’s “best interests”.

I won’t repeat the full medical evidence (you can read the judgment in full here), but here is a summary of the uncontested medical conclusions.

From doctors. Not anyone in government.

Here is the relevant legal test as to what constitutes a child’s “best interests”.

And here are the court’s (not the government’s) conclusions.

Again, if Liz Wheeler’s training as a lawyer/neurologist/paediatrician/lobotomised Trump fangirl compels her to reach to an alternative informed opinion, we are all ears.

Now that is the first judgment in the Family Division of the High Court.

Find below the subsequent judgments as the case progressed through various layers of appeal (helpfully collected by David Wood):

Of particular interest may be the below paragraph from the Court of Appeal’s second judgment. It deals with the “legal advice” given by the Christian Legal Centre and spreads across social media, which I suspect informs Liz Wheeler’s opinions.

The “advice” was entirely bogus.

Court of Appeal’s second judgment.

Other snippets from that judgment.

The barrister acting for the parents submitted that the court should not consider Alfie’s best interests, but should subjugate them to the wishes of his parents.

The court described this as “startling”. That is judge-speak for “batshit”.

Court of Appeal’s second judgment.

Addressing the issue as to whether Alfie should be taken to Italy, the medical evidence was clear.

Court of Appeal’s second judgment.

Liz Wheeler will see, and must retweet to her followers, that the decision was based entirely on an assessment of Alfie’s best interests.

Not on “cost of treatment”. Nothing to do with “socialised medicine” or “death panels”.

Solely what is medically best for a very sick child.

If Liz Wheeler can read the judgments and explain where, medically, the experts are wrong, then she deserves a hearing.

If not, her opinion is worthless and she is monstrously self-publicising over a family’s most unimaginable tragedy.

So, to summarise:

  • Government was not involved at all in the decision;

  • Decision was based solely on the assessment of Alfie’s best interests;

  • Medical evidence is overwhelming;

  • Christian fundamentalists are lying about the law in order to exploit a tragedy;

  • Twitter idiots are fuelling fire.

Nobody but the tragic handful of families who have had to attend court proceedings to litigate whether their child lives or dies can begin to imagine what Alfie’s parents are going through. That is I hope obvious, but worth bearing in mind. This story involves real human lives.

That said, people are of course entitled to form and express a view. Some will read the judgment and agree that the medical staff have done everything in their power to help, and that the court has reached the right decision in identifying what is in the child’s best interests.

Some will not. Some may disagree with the medical conclusions. Some may disagree with the principle at the heart of this case, namely that the best interests of the child take precedence over the wishes of the parents. (If this is your view, you may want to ask yourself if there are any parental wishes you would not allow to be paramount. Genital mutilation, for example. If you say “Well yes, there must be limits when a child is at risk of suffering”, then you’re closer to the legal position than you perhaps realise).

But whichever view you lean towards, you should, I respectfully suggest, obey three rules of engagement before doing battle on this terrain.

Firstly, read the court judgments below. They contain all the relevant medical and legal info. They’re long and a bit complicated, but this is a complicated case. Acquaint yourself with the facts before deciding you are right and somebody else is wrong.

Secondly, don’t lie, or dissemble, or deceive. If your argument is good, make it on its merits. False claims of “socialised death panels” or “government murder” or doctors killing out of spite towards Alfie’s parents (see below), do nothing but spread misery. Just don’t.


Thirdly and simply, if you can’t agree to those two rules, just leave the field. You are contributing nothing but uninformed, angry noise, either because Dunning-Kruger has got you, or because you spy an opportunity to exploit a family’s grief for self-promotion. Neither is good.

Finally, perhaps afford your opponents the generous assumption that they don’t revel in the killing or torturing of babies, but perhaps just have a different view on an incredibly difficult issue.🔷

Discover The Secret Barrister’s book:

Embed from Getty Images

(This piece was first published as a Twitter thread and turned into the above article with the purpose of reaching a larger audience. It has been minorly edited and corrected.)

(Cover: Dreamstime/Oleg Dudko.)