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Well the child was a UK citizen and the Italians only gave citizenship as part of this issue, so whether Italy thinks its torture or not may or may not be relevant depending on your point of view. If you can find a jurisdiction that allows you to beat your child with a coathanger to death (clearly not the case here, of course) and Childabusetopia offers you and your child citizenship so that you can take your child there, should the UK government allow you to do it, if it thinks such a thing is torturous?
Just as with all exercises of state power it would in theory be enforced with violence. If the parents had attempted to flee with the child to Vatican City, I imagine they would have been arrested, should the police have been aware of it in time. In general the courts don't have to take full custody, they can simply mandate certain decisions are made (or not made), and only take full custody if the parents continue their course of action.
For example where Jehovah's Witness children were treated with blood products (after doctors going to court), the child is still generally left with the parents. The courts aren't saying all your decisions are harmful to your child, just that this one is. For example in this case, treatment was rendered but full custody was not sought or given by the court.
Moylan said he hoped that the boy’s parents would understand. “I am extremely grateful to [the boy’s] father for so clearly and calmly explaining to me the position held by himself and [the boy’s] mother,” said the judge. “I have no doubt at all that they love their son dearly. I also have no doubt that they object to the receipt by [their son] of a blood transfusion because of their devout beliefs. I hope they will understand why I have reached the decision which I have, governed as it is [their son’s] welfare.”
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