He noted that in the Gard case, the parents attempted to transfer to transfer the child to the United States to undergo an experimental treatment for his condition.
"In the one case, it was experimental treatment, but it was experimental treatment offered as part of a bone fide study by a bone fide doctor at a bone fide hospital here in the US. So in that case they were pursuing an approach that you could certainly call extraordinary rather than ordinary means of treatment, but there's nothing wrong with that. I think it's within the rights of the parents to decide whether to pursue that kind of a treatment or not."
He noted that in both of the UK cases, the question was not whether or not to pursue an alternate form of treatment, but rather whether or not to continue basic life-saving measures.
Miller said the only similarity he sees between the UK cases and the Florida case is the fact that the state overruled the wishes of the parents.
"This [Florida] case, in multiple respects, is almost like the opposite of what was going on in the Charlie Gard and Alfie Evans cases," Miller said.
"In terms of what the parents are trying to do, and in terms of what the state is trying to do...there's absolutely no inconsistency in siding with what the state is doing in this present case and siding with the parents in those earlier cases."
'An abuse of parental rights'
"I suspect that the parents are genuinely sincere in claiming that what they want to do is in their son's best interest – although the fact that the father, on one occasion, attempted an act of violence against the mother that ended up injuring their son is cause for concern," Miller said.
"Nevertheless – and putting aside that point about the father's history – it seems to me that what they want to do constitutes an abuse of parental rights."
According to Fox13, the judge said the particular type of chemotherapy being given to Noah has a 70-year track record with 90-95% success rate.
"Proper treatment, based on evidence established by a tremendous amount of research, is, sadly, very difficult for the child, his parents, and other family members. It takes several years. There are side effects, including serious ones, during this period. There is the possibility of other side effects appearing years later. The fact remains that in the vast majority of cases, treatment is lifesaving, and so confers benefits that far outweigh the burdens," Miller noted.
"In contrast, there is absolutely no evidence to support the parents' view that stopping standard treatment very early, and switching to the approach that they favor, will confer any benefit. Rather, it is certain that – barring a miracle – the child will come out of remission and die of leukemia."
Miller also pointed out a fact that has been circulated in news reports about the case: that at least one of the alternative treatments that Bland-Ball mentions, known commonly as Vitamin B17, has been found by the National Center for Biomedical Information to not only be likely ineffective for curing cancer, but also bringing with it the potential for cyanide poisoning.
"Again: We ought to be vigilant about the problem of abuse of state authority. This does happen – including in the area of health-care decision making. The phenomenon of 'medical kidnapping' is not purely fictitious," Miller cautioned.
"But in the case at hand, it is clear to me that it is the parents – not the state – who are abusing their rights."
'Measure of last resort'
Father Tad Pacholczyk, director of education at the National Catholic Bioethics Center, told CNA that removal of a child from parental custody ought to be a measure of "last resort," to be used only after a "shared understanding" between the parents and healthcare professionals cannot be achieved.
"Sometimes parents may be attracted to 'alternative' treatments they came across on the internet that have not [been] tested or verified, and it may be important to spend a great deal of time and energy explaining to such parents the clear preferability of using standard treatments that have been tested and verified as efficacious for many patients," Pacholczyk said.
Pacholczyk said parents should generally be permitted to make medical judgements on behalf of minor children, especially when weighing the burdens of particular treatments such as chemotherapy- or, as in the Charlie Gard case, whether to discontinue treatment altogether.
"The decision to discontinue such interventions ultimately lies with the patient - or in this case with the parents as the child's proxy," he said.
In making such judgements, he noted, parents need to be in close communication with healthcare professionals, and avail themselves of their medical expertise, prior to reaching any conclusions regarding the proposed treatment.
"In situations where there is a standard treatment available, one that works in a high percentage of cases...it may indeed be unreasonable, and even wrong, for parents to decline such a treatment if the burdens to their child associated with its use are fairly low," he said.
"In such cases, however, the first line of attack should be not to take away the custody of their child, but to work assiduously to convince the parents to use the most effective approach."
Echoing Miller, Pacholczyk said that the family is, broadly speaking, the best place for a child, and "custody should be taken away only in clear situations of manifest danger to the child or in other evident situations of abuse or gross neglect."
Judge Palermo in the Florida case emphasized that in his view, the state had "met its burden and found clear and convincing evidence for neglect."
"Being raised through substitute arrangements set up by the state is many times more detrimental to the well-being of children than remaining within their native family setting," he said.
"State and governmental agencies are almost invariably worse at caring for the needs of children than the child's own parents, even when those parents may not exercise perfect judgment or may lack ideal parenting skills."