Article Text
Abstract
This paper, pursuing themes indefatigably defended in this journal and elsewhere by Professors Jenny and Celia Kitzinger, explains what led me to write my own advance decision (AD) to refuse life-prolonging treatment if I become legally incapacitated to make my own healthcare decisions for longer than 3 months and am medically assessed as very unlikely to regain such legal capacity. I attach my Advance Decision to Refuse Life Prolonging Treatment to the online version of this paper for comment advice and possible general interest. I argue that while a Supreme Court judgement in 2013, followed by a Court of Protection judgement in 2015 greatly ameliorate my earlier concerns about excessive judicial emphasis on the sanctity of life, certain current requirements in the Code of Practice to the Mental Capacity Act 2005 and in the Rules of the Court of Protection, especially Practice Direction 9E, concerning permanent vegetative state and minimally conscious state, seem clearly to contradict aspects of that Supreme Court judgement. If the logical implications of those legal requirements were thoroughly implemented medical practice would be substantially and undesirably skewed towards provision of treatments to prolong life that are unwanted, non-beneficial and wasteful of healthcare resources. I urge that these legal requirements are modified to make them consistent with the Supreme Court's judgement in Aintree v James.
- Ethics
Statistics from Altmetric.com
Linked Articles
- The concise argument
- Disorders of consciousness
Read the full text or download the PDF:
Other content recommended for you
- Withdrawing clinically assisted nutrition and hydration (CANH) in patients with prolonged disorders of consciousness: is there still a role for the courts?
- Withdrawing artificial nutrition and hydration from minimally conscious and vegetative patients: family perspectives
- Withdrawing and withholding artificial nutrition and hydration from patients in a minimally conscious state: Re: M and its repercussions
- Procedure, practice and legal requirements: a commentary on ‘Why I wrote my advance decision’
- A matter of life and death: controversy at the interface between clinical and legal decision-making in prolonged disorders of consciousness
- Court applications for withdrawal of artificial nutrition and hydration from patients in a permanent vegetative state: family experiences
- Causes and consequences of delays in treatment-withdrawal from PVS patients: a case study of Cumbria NHS Clinical Commissioning Group v Miss S and Ors [2016] EWCOP 32
- When ‘Sanctity of Life’ and ‘Self-Determination’ clash: Briggs versus Briggs [2016] EWCOP 53 – implications for policy and practice
- It is never lawful or ethical to withdraw life-sustaining treatment from patients with prolonged disorders of consciousness
- Can ‘Best Interests’ derail the trolley? Examining withdrawal of clinically assisted nutrition and hydration in patients in the permanent vegetative state