The father of a seriously ill 20-month-old boy broke down in tears as a court was told further hospital treatment would be “futile”.
Tom Evans and Kate James, both 20 and from Bootle, Liverpool, want to take their son Alfie abroad for treatment.
The hearing to decide if life support should be withdrawn from Alfie, who has a mystery illness, was stopped briefly while Mr Evans was comforted by family.
UK doctors said continuing treatment was unkind, the court heard.
Alfie is in a “semi-vegetative state” and has a degenerative neurological condition that has not been precisely diagnosed.
‘Catastrophic brain degradation’
Mr Justice Hayden, who told the court he himself had had the “privilege” of visiting Alfie in hospital, said: “Everybody in this court shares the same objectives, everybody wants the best for Alfie.”
Alfie’s parents believe he responds to them, and his father told reporters outside court he was “improving healthwise”.
But the High Court, sitting in Liverpool, heard any movements by the child are spontaneous seizures as a result of touching.
Michael Mylonas QC, representing the hospital, said: “One of the problems of this case is they look at him and, barring the paraphernalia of breathing and feeding, he’s a sweet, lovely, normal-looking boy who opens his eyes, [and] will smile…”
Mr Mylonas said scans of Alfie had shown “catastrophic degradation of his brain tissue” which was getting worse.
He said that, at the request of the parents, three medical experts from the Vatican-linked Bambino Gesu Paediatric Hospital in Rome had visited Alfie in Alder Hey.
They had reached the same conclusions in terms of the “complete futility” of trying to find a cure or alleviating his seizures.
The Italian experts had suggested operations to help Alfie breathe and feed and keep him alive for an “undefined period”.
But Dr Martin Samuels, an expert in the ventilation of children, believed such operations were “inappropriate”.
“I think we are all agreed from the medical perspective that life expectancy is limited,” he said.
Prof Helen Cross told the court that tests showed Alfie only displayed brain activity when he was having seizures.
She said Alfie’s scans were “highly abnormal” with an estimated loss of 70% of his brain nerve fibre.
This was not reversible, she said.
“Prolonging his life unnecessarily is not a way to go considering his brain is being progressively destroyed and there is no prospect of recovery,” she added.
Supporters wearing T-shirts saying “release Alfie Evans” are also at the two-day hearing.
Despite mediation between the parents and specialists caring for Alfie at Alder Hey Children’s Hospital in Liverpool, the city’s family court will decide the child’s fate.
It follows a preliminary hearing at the High Court in London last year when Mr Justice Hayden said everyone wanted what was best for Alfie, but ruled he would make a decision if agreement could not be reached after hearing from both sides.
Doctors at Alder Hey believe they should stop “mechanical ventilation” for Alfie, who was born in May 2016.
The Bambino Gesu Hospital was also involved in the case of terminally-ill Charlie Gard, asking British doctors if he could be transferred to their care.
It came after Pope Francis called for his parents to be allowed to “accompany and treat their child until the end”.
Charlie had mitochondrial depletion syndrome, a rare genetic condition which causes progressive muscle weakness, and died in a hospice at 11-months-old.
The hearing will continue with more expert evidence on Friday.