The Children Act

When a court determines any question with respect to … the upbringing of a child … the child’s welfare shall be the court’s paramount consideration. —SECTION 1(A), THE CHILDREN ACT, 1989

In his latest book, The Children Act, Ian McEwan presents the reader with a series of moral conflicts that do not lend themselves to an easy solution. The setting is London, a summer of incessant rain, when Fiona Maye, a British High Court Judge in the Family Division, must resolve the disputes of families, the faithful, and infirm.

There is also the nasty business of her private life. Her long time husband wants to embark upon an affair with 28-year-old statistician. He has no desire to leave Fiona, but rather wants “one big passionate affair” before he drops dead. Fiona kicks him out of their home, changes the lock on the door, and tries to get on with her work.

She must decide the fate of the children of divorcing Jewish parents who are disputing the nature of their daughter’s education. There is the case of Catholic parents who refuse to separate their conjoined twins, even if it means they will both die. If she permits the separation, only one will die, leaving the other to live a fairly normal life.

…she found her argument in the doctrine of necessity, an idea established in common law that in certain limited circumstances…it was permissible to break the criminal law to prevent a greater evil…Regarding the all-important matter of intent, the purpose of the surgery was not to kill Matthew but to save Mark.

The surgery was performed, all concerned viewed her decision as correct, and public interest almost instantly faded and moved on.

But the heart of The Children Act deals with a young Jehovah’s Witness leukemia patient, Adam Henry, whose parents refuse to permit a blood transfusion that would save his life. Jehovah’s Witnesses expressly forbid blood transfusions that would mix their blood with that of another human being.

Yet, Adam is only a few months shy of his 18th birthday; under British law he would be allowed to decide for himself. The issue is coming to a head, as Adam is nearing the end of the period when transfusions can save his life.

The hospital requests an emergency hearing to treat Adam with a transfusion. Adam, under the sway of his parents and religious beliefs does not want a transfusion. Fiona listens to the arguments in court.

It is argued that the court should be extremely reluctant to interfere in a decision regarding medical treatment made by a person of evident intelligence. In opposition, a case is made that the court should be guided by an earlier decision in which it was affirmed that the welfare of the child should dictate any decision.

How should Fiona rule? To decide, she first takes the unorthodox step of visiting Adam in the hospital. She observes a highly intelligent young man, who writes poems, reads them to her, and plays the violin with a fair amount of skill. They talk, she asks questions, become friends in a way, and Fiona leaves with a clear view of how she should rule.

“Consequently, I overrule the wishes of A and his parents. My direction and declaration are as follows: that the agreement to blood transfusion of the first and second respondents, who are the parents, and the agreement to blood transfusion of the third respondent, who is A himself, are set aside. Therefore it will be lawful for the applicant hospital to pursue the medical treatments of A they regard necessary, on the understanding that these may entail the administration of blood and its products by transfusion.”

The story does not end there. It is best left unrevealed to a future reader. The moral quandaries of The Children Act and the way they are presented by McEwan captured my interest from the first pages. The ending did surprise me, but in no way diminished the pleasure of reading yet another fictional gift from Ian McEwan.