A two-year-old girl has passed away after her life support machine was switched off with her “parents by her side” according to a spokeswoman for her family. Alta Fixsler suffered a brain injury at birth and had been in Manchester University hospital since the day she was born.
Medics treating the ill child said she had no prospect of recovery, however her devoted parents wanted to explore other options for Alta, including pursuing treatment abroad.
A Supreme Court ruling in May said that Alta could have her life-sustaining treatment withdrawn. However, Alta’s parents, Chaya and Abraham Fixsler, took their appeal to the European court of human rights, arguing that such a move was against their religious beliefs and their rights as parents.
This week, they lost that appeal to keep British-born Alta’s life-support on, leaving them “devastated”.
In a letter sent to the Fixslers on Monday evening, the ECHR said it rejected their appeal and agreed with the UK court’s decision to allow the withdrawal of life-support and place Alta on end-of-life care.
Manchester University NHS Foundation Trust withdrew Alta’s life support this week after the loss of the court appeal, a decision Alta’s parents described as “devastating” according to their lawyers. Alta’s family press officer confirmed the “sad news” of her death to the British press on Monday night.
Her parents “only want to see every option explored to try and save their daughter’s life”, lawyers added earlier this month. Just last week, the US state department granted Alta a non-immigrant visa to travel to the US for assessment for possible treatment. Alta’s parents are Isreali citizens, while her father also has US citizenship. Hospitals in Israel also said they were willing to take on responsibility for Alta’s care.
Speaking on the family’s behalf, David Foster, a partner at the law firm Moore Barlow, said Alta’s religion had not been sufficiently considered. “In Jewish culture, one becomes a member of the faith at conception and Alta’s religion forbids the withdrawal of life-saving care.
“We also believe that excessive weighting has been given to ‘causing pain’ as a factor in the decision. We argue that Alta would feel no more or less pain being transported to a hospital in Israel than she would lying in a bed in Manchester – but her chance of further treatment has been denied her regardless,” Mr Foster said.
His comments stand in contrast to those of Prof Dominic Wilkinson, a consultant paediatrician at John Radcliffe hospital in Oxford and director of medical ethics at Oxford University. Earlier this week, Prof Wilkonson claimed: “Medicine cannot help [Alta] any longer.”
“To keep her alive on machines in a state of consistent pain without any prospect of improvement, with just the prospect of continuing in what [doctors] describe as a state of perpetual silence and darkness … is to harm her,” he told BBC Radio 4.
However, the treatment of Alta had prompted widespread international outcry during the legal battle to keep her alive, with US Senate majority leader Chuck Schumer slamming the decision as “wrong on so many levels”.
Schumer raised the issue in a meeting last month with UK Prime Minister Boris Johnson. Speaking to Orthodox Jewish newspaper Hamodiya, he said he condemned the British decision.
“I extend my prayers and support for the Fixsler family during this very difficult time. May Alta’s memory be a blessing,” Schumer said. “I continue to believe the policy followed here was wrong on many levels and regret that our multiple, and legally and morally, well-grounded pleas were unheeded by the British authorities.”
In June, Israel’s then-president Reuven Rivlin directly called on Prince Charles to intervene in the case, describing it as “a matter of grave and urgent humanitarian importance.”
“It is the fervent wish of her parents, who are devoutly religious Jews and Israeli citizens, that their daughter be brought to Israel,” Rivlin wrote. “Their religious beliefs directly oppose ceasing medical treatment that could extend her life and have made arrangements for her safe transfer and continued treatment in Israel.”
Almost as soon as Alta’s story become news, her case drew strong comparisons to that of Charlie Gard and Alfie Evans, British toddlers who prompted recent end-of-life court battles (in 2017 and 2018 respectively). Similarly, in both of those cases, the NHS refused to discharge the children for experimental treatment overseas, arguing that they had no chance of recovery and this palliative care was the most ethical route.
In all three cases, British authorities were adamant that doctors, not the parents, were the ones best qualified to determine what constituted a humane end for these children.
David Foster, the Fixsler’s, barrister, a specialist in pro-life cases such as these, and he explains that there are a number of reasons why this is the third such case to come out of the UK in recent years.
“I’ve been doing these cases for a long time, and they come in front of the courts every few months, but don’t get to the media. What’s different about the UK, as opposed to Israel or Germany, where I’ve worked with doctors, is that in those countries you’ll often hear doctors say, ‘I wouldn’t dream of withdrawing support.’ But in Britain, which has a more secular-liberal culture, doctors will make that decision.”
In one heartrending report from after the appeal was rejected, Alta’s father Abraham is stated as saying: “We’re not public people, and this has been very hard on our lives. We feel like the UK is keeping us hostage. I’m not asking for money, just to let us go […] She’s a fighter.”
Baby Alta’s tragic story started from a complicated birth in 2019 during which she was starved of oxygen for more than 25 minutes.
“Our oldest, a boy, was then five years old, and we’d been expecting a healthy baby,” her father said in an interview. “So after she was born, and they resuscitated her for 10 to 15 minutes, the doctor warned us that she wouldn’t live more than a few hours, and that we shouldn’t get too close to the baby.”
“She’s a fighter, and she started to get a bit better,” says Avraham Fixsler. “But the doctors wanted to declare her brain-dead, which would have meant that all care could be withdrawn. I said, no, there’s a bit of movement. I had a feeling, and that was confirmed when they did some brain scans.”
In Alta’s first days, the Fixslers encountered a senior doctor in the NICU, changing his mind on Alta’s worth. The doctor told the couple that given the extent of Alta’s brain damage, the baby would have a very short lifespan and a poor quality of life.
Alta’s father said: “I told him, ‘The One Who chose to give her to us will decide when to take her.’ The doctor almost cried, and then said, ‘If this is what you want, we will try to do everything to help her.’ Two weeks later, that doctor told me, ‘Your words are still ringing in my ears.’ ”
Alta’s parents’ fight to keep her alive was supported by Chayim Aruchim, an American Agudah-affiliated organization specializing in end-of-life issues. The organisation maintained that the parents should do everything they could to keep their child alive.
According to the Hamodia newspaper, Alta was surrounded by her parents when she died who kissed her as she was taken off the machine. A minyan, or quorum of men, also gathered around her bed, offering prayers.
The paper reported that she survived for a further 90 minutes before she died.
Reports stated she would be brought to Israel for burial after a funeral ceremony was held late Monday in Manchester.