The parents of terminally ill toddler Alfie Evans will appeal for a second time against a judge's ruling that stops them taking their child to Rome for further treatment.
After a series of legal appeals the high court upheld an earlier ruling that said it was in the 23-month-old's 'best interest' for Alder Hey hospital in Liverpool to remove his life support and treat him with palliative care.
Doctors had previously told the court there was no prospect of Alfie's recovery.
Parents Tom Evans, 21, and Kate James, 20, insist recovery is possible and want to take him to the Vatican-linked Bambino Gesu hospital in Rome.
But at the end of an emotional three hour hearing in Manchester on Tuesday afternoon Mr Justice Hayden ordered the parents to work with doctors to move Alfie off intensive care and on to palliative care.
Hayden rejected the arguments of barrister Paul Diamond, of the Christian Legal Centre, who claimed the boy's condition was 'significantly better' than previously realised after he had continued breathing unassisted for several hours after his ventilation was removed.
Hayden criticised the Christian Legal Centre and said the fact he was still alive was a 'shaft of light' and a 'special opportunity' for his parents to be with him, not the time for more legal appeals.
He said court witness statement prepared for Alfie's father was 'littered with vituperation and bile', doing the parents 'far more harm than it does them good'.
He was also heavily critical of the Christian Legal Centre's Pavel Stroilov, who is not a lawyer but acts as a case worker. He described Stroilov as a 'deluded and fanatical young man' in danger of imprisonment for contempt of court after he advised the couple they had a right to remove Alfie from the hospital, despite a court order saying the exact opposite.
'This represents the final chapter in the case of this extraordinary little boy,' said Hayden.
However the Christian Legal Centre has made clear it will launch an emergency appeal of the decision which will be heard this afternoon.
The family have now lost multiple legal cases in the high court, the court of appeal, the supreme court and had their case rejected by the European court of human rights.
Their case to bring Alfie to Italy was bolstered after Pope Francis voiced his support for the family following a meeting with Tom Evans in Rome last week.
However Catholic bishops in the UK have been much more hesitant to back their case. They released a statement supporting the professionalism of doctors at Alder Hey hospital and said the court's rulings must be respected.
'It is tragic that parents and the staff are not able to come to agreement. We pray for a coming to agreement for the way forward,' Bishop John Sherrington told journalists last week.
'But the way dispute is resolved in this country is through the legal system and therefore if there are other views they must be presented through the legal system.'
He declined to offer specific support for the Evans' appeal to fly Alfie to Italy, leading to criticism from some leading Catholic figures.
The president of Bambino Gesu, Mariella Enoc, flew to Liverpool on Monday to offer her support and help facilitate a transfer to Rome but said her offer was rebuffed.
'I feel totally impotent. I'm here and I'm ready to do whatever they ask me. The hospital knows I'm here but they told me they don't want to talk to me,' she said
