Charlie Gard has been given legal and permanent residence in  US by congress in order to allow him to fly to America for treatment.Jeff Fortenberry, Republican U.S. Representative for Nebraska, tweeted ‘We just passed amendment that grants permanent resident status to #CharlieGard and family so Charlie can get medical treatment he needs.’  It is the latest move by US lawmakers who are determined to keep up the pressure on Great Ormond Street doctors in the on-going international political row over the 11 month’s old’s medical care.

But legal sources told Charlie is subject of a High Court order and it made no difference what passport he held.

And last Friday,  judge made it clear it would be illegal for Charlie to travel to America without his permission.The parents’ barrister Grant Armstrong told the parents were of the view that legally it was up to the hospital to change its mind and allow Charlie to be transferred.But Mr Justice Francis said effect of the various rulings meant the court’s permission was required.

How can doctors end Charlie’s life against his parents’ wishes?

Great Ormond Street took Charlie’s case to High Court and a judge agreed to allow them to end Charlie’s treatment because it was not in his ‘best interests’ after he agreed it will cause him pain and will not improve his condition. The Court of Appeal, the Supreme Court and the European Court of Human Rights all rejected appeals by his parents Chris Gard and Connie Yates, who believe they should have final say on their son’s treatment.In Britain  rights of the patient override the wishes of the parents if doctors disagree. For example there are several cases where Jehovah’s Witnesses are given a blood transfusion by doctors despite religious objections from parents.

Can the doctors change their mind and not turn off his life support?

Yes. Great Ormond Street could go back to  High Court to stop the order they fought for this year. Process of gaining a Consent Order could be done on an urgent basis and completed in less than two hours. Experts have said  this is the only way Charlie could travel to America or Rome for treatment because his parents’ appeals appear to have been exhausted.

Can the hospital stop his parents taking him to America without permission?

Yes. If doctors believe that any parent will cause suffering to their child, police can be called in to arrest them using Powers of Protection legislation.

Why won’t the hospital let Charlie die at home?

Connie Yates and Chris Gard say doctors have denied their ‘final wish’ to take Charlie home to die. Travelling to a hospice was also denied. While judges ruled that his treatment should end, there is nothing in  judgments that says the little boy cannot be outside the hospital. Great Ormond Street refused to tell MailOnline on what basis that decision was taken.

If parents still refuse to accept treatment should be withdrawn, can  hospital end it anyway?

Yes. Police could be called in to facilitate treatment being ended if parents were violently preventing it although it is highly unlikely this would happen. Doctors are more likely to try to ‘persuade’ parents to let it happen.If the parties remain at loggerheads for a long period  hospital could go back to court for an injunction and ask a judge to set a deadline for treatment to be withdrawn. A less stringent deadline for Charlie’s life support machine to be shut off was at Midnight last Wednesday, but this has lapsed to allow his parents and loved ones to say goodbye.

He told ‘It would be entirely wrong for him to be transferred without my being involved.’ He added that if hospital did change its mind to allow the baby to go, he would be ‘bound to agree’.

If doctors believe that a parent will cause suffering to their child, police can be called in to arrest them using Powers of Protection legislation.In  case of young cancer sufferer Ashya King his parents faced a European Arrest Warrant after absconding with their son who was in hospital. Charlie’s parents recently released a new photograph of their little boy where he appears to be looking at a toy to debunk his doctors’ claims he is blind.Connie Yates and Chris Gard say the poignant image, taken last Friday, is proof that Great Ormond Street Hospital is wrong to write off their 11 month’s old son. His doctors say he is blind, deaf, unable to move and badly brain-damaged and believe it is ‘cruel’ to let him live any longer. Mail can reveal that his British clinicians emerged from a crucial summit about his fate yesterday still convinced he should be allowed to die.They apparently failed to be persuaded by American neuroscientist Dr Michio Hirano, who flew back to New York last night.Dr Hirano and an expert from Pope’s hospital in Rome spent five and a half hours trying to talk round Charlie’s doctors.Last night his mother Connie Yates revealed Charlie was set to undergo more tests. They could decide if he is fit to undergo experimental treatment on his brain condition.She added ‘Our gorgeous baby boy is still stable. We are at his bedside and feel satisfied he is not suffering or in any pain.’As Charlie’s loving parents, we are doing  right thing for our son in exploring all treatment options.’Dr Hirano, from Columbia University Medical Center, is offering to try the experimental therapy. It has never been tested on any human or animal.The expert is at  forefront of researching Charlie’s rare form of mitochondrial disease, and told the High Court last week there was a ‘small but significant’ chance of improvement.But that was before two brain scans that the 11 month’s old had on Sunday, his first since April. He had an MRI scan and an electroencephalogram (EEG) to monitor brain activity for more than 30 minutes.Neither results, nor Dr Hirano’s view of them, have been made public, but were central to yesterday’s meeting of experts at Great Ormond Street Hospital (GOSH) in London.Dr Hirano,  Rome doctor and Miss Yates were all hoping to convince GOSH doctors to let them try the treatment.

How does ‘legal permanent residence’ differ from ‘citizenship’?

Becoming a legal permanent resident is also known as getting your green card. You are not a US citizen but you have the right to live and work in  US permanently.   But they faced a GOSH team including Charlie’s consultant paediatric intensivist, consultant paediatric neurologist, and an expert in mitochondrial disease. A GOSH spokesman told its position had not changed since last week, when it said Charlie had ‘no quality of life and no real prospect of any quality of life’.Last night Miss Yates said she and Charlie’s father Chris Gard were ‘so grateful to Dr Hirano and the other clinicians for coming to see Charlie’.She added: ‘Charlie will be having some more tests shortly.’Miss Yates was allowed to attend the summit after convincing  High Court judge she should be there. It started at 7.30am and lasted until 1pm.Mr Justice Francis is due to read a transcript of  meeting before the next hearing, likely to be this Friday.Charlie’s parents have waged a four month legal battle to prevent GOSH removing his ventilator. His condition means his lungs are too weak to function by themselves.His parents say his condition is not this bad and provided Daily Mail with a photo of him with his eyes open taken last Friday. The High Court has told it would be kindest to let him ‘slip away’. Court of Appeal, Supreme Court and European Court of Human Rights agreed.Charlie has survived three decisions to withdraw his ventilator, but was saved each time by appeals by his parents and interventions from Pope Francis and Donald Trump. Then Dr Hirano and six fellow experts wrote to GOSH offering ‘new evidence’, and  High Court reconvened.Mr Justice Francis will give his verdict next Monday or Tuesday.

Dr Michio Hirano is offering to try the experimental therapy

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