The stakes in Court 49 of the High Court could not have been higher. Mr Justice Holman had to weigh the life of an 18-month-old boy suffering from the most severe form of spinal muscular atrophy, a progressive and degenerative genetic condition. The boy’s doctors believed his life to be intolerable and that the ventilator keeping him alive should be switched off. His parents argued that he had a right to life. Despite his near-paralysis, they testified to being recognised by their son and also being able to detect his apparent attempts to smile.

After seven days of listening to the most wrenching evidence, Mr Justice Holman accepted that the child, MB, experienced “almost relentless discomfort, periods of distress and relatively short episodes of pain”. It was, he said, “a helpless and sad life”. But he rejected the hospital’s petition to remove the boy’s life support, which would have condemned him to death within days. He was right to do so.

In the four decades since Britain suspended and then abolished capital punishment, judges have rarely had to exercise power over life. But such instances are increasing. Advances in medical science and changing social mores surrounding euthanasia have made right-to-life and right-to-death cases more frequent. Their essence — honourable but clashing beliefs over the ultimate question — ensure that they will never be less than anguished, and often unbearable, affairs. It is to the credit of MB’s parents and his doctors, recognised as such by the judge, that they conducted themselves with impressive dignity throughout. That dignity was also shown by the judge.

The anonymity afforded them may have helped. The glare of publicity in broadly similar US cases can inflame feelings and turn proceedings ugly or political, or both. But Mr Justice Holman was correct to uphold a BBC request for media access to the courtroom, which was initially to be denied. At the very least it allows the vast majority of us to recognise how fortunate we are, and, in our own ways, to grapple with these profound issues.

Although Mr Justice Holman ruled in the family’s favour, it is hard to regard his decision as a victory, and certainly not one that will afford celebration. As he said in a sagacious judgment, MB will die, probably within a year, though it may be sooner. The boy’s parents, particularly his mother, were mistaken in believing that as-yet undiscovered drugs would come to their rescue. They would never be able to take their son into the hospital grounds, let alone to their home.

Spinal muscular atrophy is a cruel condition, trapping a possibly alert mind in a failing body. The list of benefits and burdens to MB from continued life, as provided to the court by the lawyer appointed to represent the child’s interests, was slanted to the latter. But the former included the possibility that he might derive “some comfort/pleasure from Barney the Dinosaur/Teddy”. They, and his awareness of his family, are all that MB has. But, as the judge, said, these assets are “precious and real”. Justice, as far as possible in such a tragic case, was done.

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