"I am satisfied...that there is a responsible body of relevant professional opinion which supports this innovative treatment.

"That is, in my view, subject to the seriousness of the risks involved and the degree of benefit that might be achieved.

"The benefits that might be gained from the pentosan polysulphate infusion are less tangible and more difficult to assess.

"None of the medical witnesses entirely ruled out the possibility of some benefit.

"Even though the patients will not recover, it seems to me that the concept of 'benefit' to a patient suffering from vCJD does encompass an improvement from the present state of illness, or a continuation of the existing state of illness without deterioration for a longer period than might otherwise have occurred.

"At best there might be some improvement. The fact that both JS (Jonathan Simms) and JA have good days and bad days allows for the possibility that some nerve cells might respond to the infusion.

"Where there is no alternative treatment available and the disease is progressive and fatal, it seems to me to be reasonable to consider experimental treatment with unknown risks and benefits, but without significant risks of increased suffering to the patient, in cases where there is some chance of benefit to the patient.

"A patient who is not able to consent to pioneering treatment ought not to be deprived of the chance in circumstances where he would have been likely to consent if he had been competent."

Best interests?

"I am satisfied from all the evidence that both JS and JA have a life that is worth preserving and that any treatment that might be beneficial would be of value to them.

"The chance of improvement is slight but not non-existent.

"Is a prolongation of life as it is led worthwhile for JS and JA. The parents of each say emphatically yes.

"There is undoubtedly evidence that there is some value to their lives.

"The unanimous medical evidence was that the views of the families carried great weight. I agree.

"Both families are deeply and sincerely committed to this treatment."

The trust's conduct

I am however somewhat concerned at the way in which this matter has come before the court.

"It is not unusual for the High Court to be asked by an NHS Hospital Trust to decide whether medical or surgical treatment would be lawful.

"I am somewhat concerned to find that I have been asked to declare whether the proposed treatment is lawful, and then find that the hospital, to which the consultant surgeon is attached with patients properly referred to him, may not choose to accept the patients for treatment.

"It would be an unacceptable academic exercise for a High Court judge, exercising the inherent jurisdiction of the High Court, to heart a case and hold that the treatment is lawful, if after the judicial decision is made the NHS hospital trust is not then prepared to carry it out.

"In the case of the families of those suffering from as tragic an illness as JS and JA are, it would be an unbelievably cruel blow to have the High Court say yes to the treatment and the two committees of the hospital trust to say no.

"If the committees reject the applications now made by Mr T (the surgeon) on behalf of his two patients, I would invite the Department of Health, in this unique case, to consider how best to help these families."

The order

"It would be lawful and in the best interests of the defendents JS and JA for them to receive medical treatment for the condition vCJD by intracerebral infusion of pentosan polysulphate and to undergo surgical and other ancilliary treatment to enable this to happen."