But there are two important points that need unwrapping. The first is that, as the courts say in several ways, the interests of the child, Alfie, should be “paramount.” That is said to be the “gold standard” of judgment concerning cases involving minors, whether a custody settlement in a divorce case or a dispute over the child’s medical care as here. This gold standard is the rule not only in the UK but also in Europe and internationally, which, the court says, strengthens the force of its decision in this case.

An obvious problem with this argument, however, is that Alfie is both a minor and incapable physically of judging his own interests. Until quite recently — indeed, I think it may still be listed in the Universal Declaration of Human Rights — the parents had the right to determine what was in the best interests of the child. Confronting this right in its judgment, the court pointed out that the Custody of Children Act in 1891 had severely qualified this parental right (and, incidentally, obligation). The courts would not give a parent full custody, for instance, if he had abandoned or deserted the child or conducted himself in some way as to show him to be a danger to the child. That legal change was later strengthened by other Acts of Parliament with the overall result that the state now ultimately exercises parental power over the child while, so to speak, leasing out that right to the actual parents on a day-to-day basis. This “gold standard” of the “paramount” interests of the child is the basis, for instance, of the intervention of the courts to prevent parents, usually for religious reasons, from refusing blood transfusions needed to save a child’s life.