Friday, September 3, 2021

Alta Fixsler

Every life is precious, no matter what one’s circumstances!

Little Alta Fixsler was born eight weeks prematurely in Royal Manchester Children’s Hospital.  A traumatic birth deprived Alta of oxygen for twenty-five long minutes causing severe brain injury and no expectation for her to live more than a day.  But with HaShem’s help coupled with the loving embrace of her parents and Modern Medicine’s gift of the ventilator, this beloved Jewish daughter survived her first harrowing days of life.  Despite Alta’s strides in weaning off ventilation and transitioning to a lower level of respiratory support or that plans were being formulated to bring her home, someone at the hospital made a series of unilateral decisions that resulted in Alta having to go back on ventilation.   After that it was only a matter of time before pressure began to mount on her parents to withdraw life support under the guise of concern for her pain and no promise of recovery or a normal life.  When Alta’s parents refused to consent, Manchester University Foundation Trust (NHS) went to Court against them and were granted guardianship and the right to withdraw her life support, r”l.

In conjunction with efforts being made on Alta’s behalf, Crown Heights Women for the Safety and Integrity of Israel and its many members around the world have sent the below appeal to British Prime Minister Boris Johnson.


To the Rt Hon Prime Minister Boris Johnson,

We were duly impressed with the United Kingdom’s humanitarian commitment pledged by yourself and fellow parliamentarians on August 18th to rescue tens of thousands of Afghanis from certain persecution and death as the Taliban take over in the wake of the US withdrawal from Afghanistan.

At the same time, however, we cannot understand why the same kind of compassion and political will has not been shown towards Alta Fixsler.

Across the globe people of goodwill from all walks of life and religions are praying for this special little girl to be given a chance.

The Lubavitcher Rebbe, the greatest lover of humanity in our time, repeatedly emphasized that acts of goodness and kindness bring light and peace to the entire world.

And so, Mr. Prime Minister, we plead with you to immediately intercede on Alta’s behalf to find a way she can leave the UK either to the US or to her home country in the State of Israel.

As we’ve no doubt you are already familiar with the particulars of Alta’s birth and her medical issues as well as the High Court’s decision, we only ask that you to consider the following three key points.

To be clear, we respect the strict separation of powers that make up the UK government and are not asking you to override in any way the Court’s ruling.

Alta and the Fixslers are Israeli citizens.

Mr. Prime Minister, Alta and her parents are Israeli citizens.  Avraham Fixsler is also an American citizen and Mrs. Fixsler additionally holds Hungarian citizenship.  The Fixslers always intended to return to their home country and have made no application for British citizenship. 

As such there can be no justification for expropriating the Fixsler’s parental rights – who are neither British citizens nor have they committed any crime on UK soil – or Alta’s right to live, simply because she sadly suffered brain injuries at birth.

Palliative care is a horribly painful way to end life.

Benign sounding terms like palliative and hospice care disguise the true ordeal a person endures when life support is taken away.

Here is what happens when ventilation is withdrawn:  First there is a physically painful struggle by the patient to breathe accompanied by panic, fear, and agitation – especially when the fight to live is deliberately being suppressed.   Saliva and secretions begin pooling in the lungs and the sounds of death rattle in the chest.

In order to “calm and comfort” the patient during this “merciful” form of legalized murder, a powerful mix of opiates, barbiturates or analgesics must be given to keep the person sedated until he or she succumbs and dies.

As much as an adult in this state might be able to reconcile their final moments – if this has been a deliberate decision to do so [and one we do not agree with] – for anyone else, especially a child, this can only be terrifying!

How can this possibly be in Alta’s best interests?!

Yet NHS has taken it even one step further.  The Court’s ruling gave room for Alta to pass away in the comfort of her parents’ home in Manchester surrounded by her loving family.

Instead, NHS unilaterally decided that Alta may only die in a hospice or in the hospital which they themselves concede is a cold, windowless environment.

Surely Mr. Prime Minister you realize the above scenarios are far more “painful” and distressing than anything that might occur during a responsible transport with appropriate pain control.

Alta does not have to die

No doubt Mr. Prime Minister you are aware that medical facilities in Israel are ready to admit Alta as a patient under their care.  Surely, there is room to reevaluate this option.

But if not, we beg you to find a way Alta can be transferred to the US where Senator Charles Shumer has procured a visa for Alta to enter the country for care and where there is widespread bi-partisan support in Congress endorsing her move.

A highly qualified medical transport is already in place to transfer Alta at absolutely no cost to NHS or the UK.

Mr. Prime Minister, Rosh HaShana, the Jewish New Year, is fast approaching.  This is the birthday of Mankind when Adam and Eve were created and judged.   The fate of Alta should be emblematic of Humanity’s appreciation for the preciousness of every life, no matter what one’s circumstances. 



  1. Senate Majority Leader Chuck Schumer (D-N.Y.) raised the issue of Alta Fixsler in a meeting with U.K. Prime Minister Boris Johnson, pressing the British leader to “overrule the hospital” that has deemed it in the best interest of the two-year-old girl that she be removed from life support.

    Johnson, in the U.S. this week to meet with President Joe Biden at the White House and speak at the U.N. General Assembly, also had a meeting at the U.S. Capitol on Wednesday with approximately a dozen Senate leaders of both parties, as well as Karen Pierce, U.K. ambassador to the U.S. At that meeting, Schumer took the opportunity to bring up the Fixsler matter with the prime minister.

    In a phone interview with Hamodia on Thursday, Schumer described his conversation with Johnson.

    “I said to him that this is very, very important,” said Schumer. “I told him I am Jewish and about the concept in the Talmud that to save a life is above almost anything else. And I said to him that he has the power to do this.”

    “The prime minister said, ‘It’s British law,’” Schumer related. “I said, ‘I know it is British law that the hospital governs, and the hospital made a decision — a wrong decision — that it’s in the best interest of the child to let the child pass away. But I said you are in charge of the hospital, because you’re the head of the National Health Service system, so you can overrule the hospital.” (continued)

  2. (continued)Schumer said Johnson was “sort of surprised” that he had brought up the Fixsler issue.

    “But he listened,” said Schumer, “and he said he’d look into it.”

    Alta Fixsler suffered a severe brain injury at birth and is unable to breathe or eat on her own. The Manchester University NHS Foundation Trust, the hospital system responsible for Alta’s care under the U.K. National Health Service, says that there is no potential for her condition ever to improve, there is no medical benefit to continuing her life support, she is suffering pain and it would be humane to remove her from life support.

    As Orthodox Jews, the Fixsler family insists that Alta remain connected to the machines keeping her alive. The family has undertaken an extensive lobbying and outreach effort, with U.S. and Israeli governments interceding with the British government on Alta’s behalf, asking that the girl, whose mother is Israeli and father is Israeli-American, be allowed to leave to one of those countries for medical treatment. Jewish charitable organizations have arranged transport, and there would be no cost to the U.K. government.

    But the British courts have repeatedly upheld the hospital’s decision to have Alta disconnected from the machines, and with legal options seemingly exhausted, a political lobbying effort is the family’s only hope.

    Schumer has been among the most active U.S. officials advocating on the Fixslers’ behalf. He has previously helped obtain a visa for her to travel to America for medical treatment, though the U.K. has not allowed her to leave. He has also had several past conversations with Pierce on the Fixsler issue. Separately, 10 Republican senators sent a letter to Biden in June asking him to “advocate to Prime Minister Johnson on behalf of the Fixsler family.”

    Schumer credited Rabbi Moshe Dovid Niederman of the UJO of Williamsburg, one of the leading activists on behalf of the Fixsler family, with “giving me the idea that the prime minister could overrule the hospital board, because he’s in charge of the hospital system.”

    Rabbi Niederman told Hamodia on Thursday that he is “grateful that this issue is on Sen. Schumer’s front burner, and that he doesn’t miss an opportunity to try to save Alta’s life. While, as a leader of our country, he has many important issues, we appreciate that he took the time to discuss this matter with the prime minister.”

    Rabbi Niederman is hopeful that Johnson will indeed intervene with the hospital. “In my years of experience in community advocacy, I’ve seen time and again that when you go to the top, things move at the bottom,” Rabbi Niederman said. “And in a case of pikuach nefesh [saving lives], we have to use every avenue possible.”

    Readers are asked to daven for the refuah sheleimah of Alta bas Alta Chaya, besoch she’ar cholei Yisrael.

  3. Pain is not a justification for assisted dying

    The case of Alta Fixsler strikes at the heart of debates around life and death

    The case of Alta Fixsler, a young girl born with catastrophic brain damage, leaves one with a sense of deep sadness at the tragic nature of life. It strikes at the heart of debates around life and the context of death, particularly during our debate over assisted suicide.

    The Royal Manchester Children’s Hospital has won legal support for removing life-support from Alta. Her parents, Hasidic Jews, have disagreed, with dissension rooted in their faith. The case hinges on the hospital’s argument that Alta experiences “constant pain.” Despite parental protestations that she is in no distress, her clinicians have argued this is simply her medication suppressing the pain. The evidence of involuntary movements, interpreted as spinal spasms, supports the withdrawing of treatment to alleviate suffering.

    And yet, as Dominic Lawson argues in The Times, how can this judgment be based on pain Alta experiences? He quotes leading pain expert Dr Rajesh Munglani, to the effect that it is nonsensical to remove treatment due to pain. Alta Fixsler can’t actually experience suffering: it is a higher cognitive function. It is highly likely she cannot experience pain because her damaged brain prevents this. According to Dr Munglani, spinal spasms do not prove pain either.

    This gets to the crux of our societal debates over what constitutes a life worth living and a death worth dying. Many who argue for assisted suicide do so on the basis on alleviating unbearable suffering. This is understandable, but is not necessarily the true motivation. In 2020 in Oregon, USA, where assisted suicide is legal, 53% said they chose this path to avoid being a burden; add in the likelihood of contributory psychological issues and pain as a reason slips down the list.

    The use of pain as a means to push arguments for assisted dying betrays a cultural misunderstanding of pain itself. Having a genetic fragile skin condition, Epidermolysis Bullosa, I am intimately acquainted with pain in its various forms, from the wearingly chronic to the excruciating acute. This is of course a burden I’d not wish on anyone. But for me the pain itself is not a reason for despair or loss of hope in life itself. The point is that my disability is a particular, concentrated example of the universal of pain we all face, given that we all exist on what Alasdair MacIntyre calls a “scale of disability”. Simply reducing life to pain and suffering as measures of life’s quality is a cold utilitarian calculus, devoid of life’s (and death’s) complexities. Questions of meaning, purpose and relationships are stripped away.

    Returning to Alta Fixsler, the question is whether she qualifies as a human person, with all the resulting rights and duties that entails. It is because her parents believe she qualifies that they wish to take her home to die. Further to this, do those like myself qualify as persons, or not? If pain and suffering are life’s main measurement, then the compassionate effort to alleviate this will end in a callous move to erase it altogether: by removing the people themselves, reduced from persons to beings, as the source of the suffering. It is already happening in places like Oregon, Holland and Belgium. We should not follow them.

  4. If your severely disabled two-year-old daughter is dying, should you be allowed to take her home for her final hours? It sounds like the answer should be a simple ‘yes’. But in the law surrounding parents, children and healthcare, nothing is that simple.

    Alta Fixsler’s parents have been repeatedly thwarted in their efforts – as they see it – to do their best for their daughter. First, Manchester University NHS Foundation Trust sought to withdraw life-saving treatment for Alta. A judge subsequently agreed that it was in Alta's 'best interests for the treatment that is currently sustaining her precious be withdrawn'. This was in spite of her parents seeking to take her to Israel for treatment. Alta has now effectively been banned from leaving the country.

    Now, as her parents make their last request – to bring Alta home from hospital – the NHS Trust is again refusing permission. This time, they appeal not to law but to logistics. According to documents seen by The Spectator, the Trust claim that Alta’s family home is ‘inaccessible to a patient trolley and is, therefore, unsafe.’ Alta’s parents disagree.

    Ivan Lewis, the former MP who served as health minister in the Blair and Brown governments, visited the house yesterday afternoon. He is not convinced by the reason given for refusing to allow Alta to die at home:

    ‘There is no justification for the hospital’s flawed conclusion that Alta will not be safe at the family home. Having reviewed the evidence I am left with an uneasy feeling of discrimination against the Fixsler family because of their religious beliefs and determination to fight for the rights of their child.’

    Lewis says there is ‘compelling independent evidence to support the parents' view that there is perfectly adequate access to the family home for the trolley which will carry Alta’.

    In response to Lewis’s statement, a spokesperson for Manchester University NHS Foundation Trust said: ‘We recognise that this is an incredibly difficult and distressing time for Alta’s family and we will continue to support them. Due to patient confidentiality, we are unable to comment further.’

    The question could now go back to the courts if neither side backs down.

    Throughout the dispute, the NHS Trust has maintained a line which has a certain internal logic. Alta is, the doctors believe, in pain; there is no chance of recovery; further care or treatment will only cause more pain; therefore her life support should be switched off.

    Her parents have argued, on the other hand, that there is no watertight evidence of Alta being in pain; and that their beliefs, as Hasidic Jews who place a strong emphasis on the duty to preserve life, should be respected.

    These kinds of cases aren’t simple. Parents do not have an absolute sovereignty over their children; in a secular society, religious convictions – even very strongly-held ones – can sometimes conflict with the law. But this case, like those of Charlie Gard and Alfie Evans, gives the strong impression that parents’ rights have been reduced practically to an afterthought.

    For one thing, the current law does not do enough to consider the importance of parents’ wishes. The High Court actually asserted that Alta might disagree with her parents:

    ‘It is more likely than not that Alta’s point of view would be that continued life sustaining treatment would not be acceptable to her.’

    Alta's case provides further proof that parents have been shoved to the margins when it comes to medical treatment for their children.

    Alta’s mother and father have bowed to the High Court’s heartbreaking judgments; they are prepared to work with the Trust in giving Alta the necessary medical support; but still, when they make their final modest request, the door is shut in their faces.

  5. The parents of a seriously-ill girl have lost a legal fight over where the two-year-old should end her life.

    Alta Fixsler's parents have been in a dispute with Manchester University NHS Foundation Trust over her care.

    They wanted her life support treatment to be withdrawn at home but the trust argued it should happen in hospital or at a hospice.

    A High Court judge has ruled Alta's treatment should be withdrawn in a children's hospice.

    Mr Justice MacDonald, who considered the case in the family division of the High Court, said he was satisfied that it was in Alta's best interests for the withdrawal of life-sustaining treatment to take place at a children's hospice.

    Alta suffered a brain injury at birth and cannot breathe, drink or eat without medical help.

    Alta's parents, who are Hasidic Jews, previously lost their fight to stop the removal of their daughter's life support, having argued it was against their faith.

    'Further pain'

    Alta's father, who cannot be named for legal reasons, previously told BBC Radio 4's Today programme that taking her home was "something that we wanted from day one when the doctors said she is not going to live more than a few hours".

    In the judge's written ruling, he said that removing her life support in a children's hospice "best accommodates Alta's welfare need for specialist care at the end of her life under a reliable, safe and sustainable system of high calibre care protected from disruption, whilst allowing, in so far as possible and consistent with Alta's best interests, the family and the community to perform the sacred religious obligations of the Orthodox Jewish faith".

    Her parents have previously failed to persuade a High Court judge to allow them to move their daughter from England to a hospital in Israel

    The trust and other medical experts told the court Alta has no chance of recovery but her parents argued it was against their faith to remove life-sustaining treatment and also against their rights as parents.

    They asked the High Court for permission to take her to an Israeli hospital or to the US, where she has been granted a visa because of her father's US citizenship.

    However, a judge ruled that it was in Alta's "best interests" to withdraw treatment and taking her abroad would expose her to "further pain".

    That ruling was later upheld by the European Court of Human Rights.

    A spokesperson for the trust said: "We recognise that this is an incredibly difficult and distressing time for Alta's family and we will continue to support them.

    "Due to confidentiality we are unable to comment further."