Minggu, 07 Agustus 2016

Resolving Medical Futility Cases in Canada after Rasouli

After the Supreme Court of Canada decided Cuthbertson v. Rasouli, several reports (here too) indicated that clinicians were "chilled" from standing up to families who they judged demanded inappropriate life-sustaining treatment.

But it look like courts and tribunals are still authorizing Canadian clinicians to stop administering life-sustaining interventions even when requested by the patient's family.  

In University of Montreal Hospital v. WL, the clinicians felt it was futile to continue mechanical ventilation and to continue the feeding for Mr. L. who was in a vegetative state.  Despite the objections of the patient's sisters, the court authorized the hospital to stop any treatment except comfort care. (HT: Hilary Young)

In re SL, the attending physician was concerned that many of the treatment being advocated by the patient's surrogate (DH) would result in pain and discomfort to SL.  He brought the case to the Ontario Consent and Capacity Board.  

The CCB first determined that there was no evidence to suggest that SL had ever expressed  any wishes regarding  treatment.  Therefore, the CCB applied an objective best interest standard.  The CCB noted that "this is an area that the Board found that deference   should be given to the medical practitioner."  The CCB directed the surrogate to consent to the recommended treatment plan (palliative care only).

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