Alfie Evans' parents lost another legal battle today as judges rejected their appeal against a previous ruling as 'totally without merit'.
Three judges at the Court of Appeal heard the case in London and upheld a ruling made yesterday that the terminally ill 23-month-old must remain in Alder Hey hospital in Liverpool for palliative care.
They said there had been no 'change in circumstances' that would allow them to reconsider the judgement of Mr Justice Hayden.
It came as the court revealed that Alfie's parents Tom Evans, 21, and Kate James, 20, had launched a private prosecution of conspiracy to commit murder against three medical staff at Alder Hey.
Jason Coppel QC, representing Alfie's mother, said the toddler was 'struggling' and needed 'immediate intervention'.
In nearly five hours of legal submissions the court heard that medical staff at Alder Hey may face charges of murder in Italy if Alfie died after the Italian government granted Alfie citizenship.
'The killing of an Italian citizen abroad is considered within the jurisdiction of the Italian criminal court,' Coppel said.
'There is a military air ambulance on standby at the request of the pope,' Paul Diamond, for Alfie's dad, said.
But the judges said Alfie's 'best interest' was the gold standard they must consider and any future action against adults was not their concern.
The parents want Alfie taken to the Vatican-run Bambino Gesu hospital in Rome for palliative care where Coppel said the approach was different.
'They are far far more likely to regard it in a child's best interests to live,' he said.
Coppel was a last minute addition to the legal team, representing Alfie's mother while Paul Diamond, engaged by the Christian Legal Centre, represented his father.
Coppel made a number of new legal arguments on the grounds of EU freedom of movement for an Italian citizen.
Diamond made largely the same arguments as he had in previous cases saying there had been a 'significant change of circumstances' because Alfie was still breathing after life support treatment had stopped.
He admitted the parents were 'clutching at straws' and said the case 'has raised some issues about the nature of life and the society we are'.
The court rejected both their arguments meaning Alfie will continue with palliative care at Alder Hey.
Lord Justice McFarlane said Evans was 'brave, unflinching, unstinting' in fighting his case but 'at each turn the court has held that what he wants is not in Alfie's best interests'.
Sophia Roper QC, representing Alfie's guardian, said there would need to be a 'sea-change' in the parents' attitude before they could take Alfie home. She said the hospital staff were worried they would secretly take Alfie to Italy if they were allowed to take him home.
Lord Justice McFarlane said there had been a 'darker side' to the support the parents had received, warning they were vulnerable and had been used by campaigning groups.
Wrapping up his argument Diamond said: 'I'm asking the court to touch base with where we are as a society.'
He added: 'I'm asking this court to get out of a judicial straight jacket and get out of a system where "best interest" means someone needs to die.'