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Who Can Let You Die?

Published online by Cambridge University Press:  29 November 2010

M. Anne Bolton Q.C.
M. Anne Bolton Q.C.
Affiliation:
Counsel for the Public Trustee of Manitoba.
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Abstract

Aging with grace and confidence would, for most people, be facilitated by the assurance that life would conclude with dignity. Unfortunately, such assurance is not available, especially if diminished competence does not allow the expression of a refusal to the continued administration of medical treatment. Health care professionals maintaining mentally incompetent patients on life supports should be aware of the legal risks of terminating treatment without valid informed consent. Yet who can give such consent? Does our law provide any guidance?

This paper will examine the Canadian legal realities of obtaining valid informed consent to cessation of medical treatment for the terminally or chronically ill. References will be made to The Canadian Charter of Rights and Freedoms and the leading American jurisprudence.

Résumé

La plupart des gens pourraient accepter le vieillissement avec plus de sérénité s'ils avaient la certitude que leur vie allait s'achever dans la dignité. Malheureusement, personne ne peut être certain de cela, surtout si une diminution des facultés rend impossible le refus du prolongement des traitements médicaux. Les professionnels de la santé qui maintiennent en vie une personne incapable au moyen d'un système d'assistance cardio-respiratoire devraient être au courant des risques que présente la cessation du traitement sans un consentement valable et éclairé. Mais qui peut donner ce consentement? Est-ce que la loi nous offre des points de repère?

Le présent mémoire traite de la réalité juridique au Canada en ce qui concerne l'obtention d'un consentement valable et éclairé pour la cessation de traitements médicaux administrés aux agonisants ou aux malades chroniques. L'auteur se réfère à la Charte canadienne des droits et libertés et à la principale jurisprudence américaine sur la question.

Keywords

Euthanasiaconsentmedical treatmentdyingincompetencylife supports
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 8 , Issue 3 , Fall/automne 1989 , pp. 238 - 243
Copyright
Copyright © Canadian Association on Gerontology 1989

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References

ENDNOTES

1. See Brophy v. New Engbnd Sinai Hospital Inc. 497 N.E. (2d) 626 (Mass. 1986);

2. Ibid., p. 632;

3. For an excellent discussion of these issues see “Sanctity of Life and Quality of Life”, Law Reform Commission of Canada, Protection of Life Series, 1979, Edward N. Keyserlingk;

4. 355 A.2d 647;

5. Supra, note 1, at p. 635;

6. For recent developments in the State of New Jersey, see In Re Nancy Ellen Jobes 529 A.2d 434 (S.C.N.J.);

7. Mass., 370 N.E. 2d 417;

8. Even less formal modes of decision making have been endorsed. See In The Matter of Guardianship of Joseph Hamlin, An Incompetent Person 689 P.2d 1372 (Wash. 1984) where the court held that family, if they are all in agreement with the treating physician regarding the patient's prognosis, may assert the personal right of an incompetent person to refuse life-sustaining treatment without seeking prior appointment of a guardian;

9. Mass., 370 N.E. 2d 417;

10. See Re S.D. 34 R.F.L. (2d) 34 (B.C.S.C);

11. “Constitution Act” 1982, s. 7;

12. See Montreal Childrens Hospital v.J. Q.A.C. 209 (Q.C.A.); Re L.D.K.; Childrens Aid Society of Metropolitan Toronto v. K and K 48 R.F.L. (2d) 164.

13. For a discussion of parens patriae, see “Eve”, by her Guardian Ad litem, Milton B. Fitzpatrick, Official Trustee v. Mrs. “E” and The Canadian Association for the Mentally Retarded and The Public Trustee of Manitoba, and the Attorney General of Canada [1986] 2 S.C.R. 388;

14. See Reibl v. Hughes [1982] 2 S.C.R. 380.