'Landmark' ruling allows man to refuse dialysis

[okarol]

'Landmark' ruling allows medical treatment snub

Posted 1 hour 27 minutes ago
Updated 1 hour 28 minutes ago

    * Map: Newcastle 2300

A Newcastle legal academic says a Supreme Court ruling allowing a man the right to refuse life-saving medical treatment on religious grounds is an important test case.

The man, aged in his 70s, did not want dialysis at a hospital run by the Hunter New England Area Health Service, in New South Wales, because he is a Jehovah's Witness.

The court ruled the man is a capable adult and is entitled to refuse treatment.

A lecturer in clinical ethics and health law, Dr Charles Douglas, says the ruling will have implications in other cases where patients refuse treatment.

"Until now there haven't been common law cases, there hasn't been judgments tested about whether ... a written plan would be respected, so this is a test case if you like and it's one that a number of people wanted to see tested," he said.

An intensive care specialist at Newcastle's John Hunter Hospital says the landmark court case will give doctors a clear direction on what to do when a patient refuses medical treatment.

Dr Peter Saul says the health service took the case to court to clarify its legal position.

"We were looking for an opportunity to clarify what you'd call the common law or the judge-made law, but there'd never been any judgments, so this is a landmark case for us because this is the first time somebody has made a judgment on this issue," he said.

"So on one level it's a very specific judgment about that case but clearly it sets out matters of principle in the judgment."

http://www.abc.net.au/news/stories/2009/08/07/2648571.htm

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Court allows dying man, a Jehovah's Witness, to refuse medical treatment on religious grounds

    * By Larissa Cummings
    * From: The Daily Telegraph
    * August 07, 2009 12:00AM

A DYING man's last request has been granted after a court allowed him to refuse medical treatment on religious grounds - even though his decision will "hasten his death".

The patient, a Jehovah's Witness identified only as Mr A, signed an advanced care directive last year stating that he refused to have a blood transfusion "even if health-care providers believe that such (is) necessary to preserve my life''.

Mr A, who has appointed two fellow Jehovah's Witnesses to act as his guardians, was admitted to the emergency department of a Hunter and New England Health Service hospital on July 1, suffering from septic shock and respiratory failure.

He was started on dialysis after his kidneys shut down but his guardians presented the advanced care directive and asked that dialysis be ceased.

After keeping him alive for two weeks by mechanical ventilation and dialysis, the health service applied to the Supreme Court on July 14 to make a ruling on whether it was justified in complying with Mr A's treatment wishes.

In upholding the patient's request, Justice Robert McDougall emphasised that the court was in no way recognising Mr A's "right to die''.

He found Mr A was "competent" when he signed the directive, which was drawn up by a solicitor.

The solicitor, Mr N, admitted he did not explain the risk of refusing dialysis to Mr A because "it was unclear whether, according to the beliefs held by Jehovah's Witnesses, there was any biblical proscription of this form of treatment''.

In addition to Mr A's directive, his guardians produced two Jehovah's Witness "worksheets" stating his attitude to various forms of medical treatment, written in his handwriting in August last year but unsigned.

On his second worksheet, under an explanation of dialysis, he said he would refuse the treatment.

In his reasons, Justice McDougall said any competent adult was entitled to refuse medical treatment on moral, social or religious grounds in the form of an advanced care directive.

"If (it) is made by a capable adult and is clear and unambiguous and extends to the situation at hand it must be respected," he said.

"On the basis of medical evidence, I accept that the result of withdrawal of dialysis will be to hasten Mr A's death. That is a consequence of the decision that he made, as signified in Worksheet 2."

http://www.dailytelegraph.com.au/news/court-allows-dying-man-a-jehovahs-witness-to-refuse-medical-treatment-on-religious-grounds/story-e6freuy9-1225758732043