evidence that the treatment was unlikely to be of any benefit to Charlie's brain. He agreed that there could be no reversal of the structure of Charlie's brain. He said that the main functioning would be improvement of weakness; some patients had improved their upper strength and four of eight patients had been able to reduce their time on ventilators, but he agreed that the effect on brain function would be less or minimal or non-existent. He said that the chances of meaningful brain recovery would be small, he described the probability as low, but not zero; he agreed he could not distinguish from vanishingly small. He said that he thought that there was only a small chance of meaningful brain function. He said that he was "in unchartered territory, especially as we do not know how much structural damage there has been". He conceded that to a large extent, if not altogether, the damage was irreversible. GOSH had determined that the chances of benefit to Charlie were vanishingly small, the effort would be futile and the treatment potentially painful for him. Hospitals in the US make the same kind of plausibility analysis when they consider experimental treatment. New York–Presbyterian Hospital would have needed approval to give Charlie the nucleoside therapy under the US compassionate-use framework. Charlie's parents felt any chance to save his life was worth trying. Their attempt to take Charlie to New York began when the London Hospital did not obtain approval to administer the experimental treatment – there was no question of its medical or technical inability to administer the treatment. Had Charlie travelled to New York a similar regulatory process would have been required. This point was not raised within the court process; the case proceeded, both in court and in the wider public debate, on the basis that the experimental treatment was not available in London but was available in New York. In evidence in April Hirano had said that he would defer to "ICU people", i.e he would not administer the experimental treatment if the intensivists at his hospital advised against it, as the GOSH ethics committee had in November 2016 and intensivists at GOSH had in January 2016. After Charlie's death, The New York Times observed that only rarely is there such intense conflict between doctors and parents. CAFCASS reports that in England, it was involved in 18 parent-doctor disputes in 2016