OTTAWA, ON October 19, 2013 – The Supreme Court of Canada ruled October 18 that Hasan Rasouli cannot be removed from life support without the consent of his family or legal substitute decision maker. The Ontario man has been comatose since 2010 and his doctors believed further life support was futile.
In a 5-2 decision, justices for Canada’s highest court ruled doctors must first obtain consent from the man’s family, or, failing that, apply for permission from Ontario’s Consent and Capacity Board, a quasi-judicial body that addresses matters of consent under Ontario’s Health Care Consent Act.
“This ruling is welcome in as much as it upholds patient rights by stating that doctors cannot act unilaterally in these circumstances,” said League President Philip Horgan. “While the case addressed a specific Ontario law, we hope the principle it upholds will guide disputes in other jurisdictions. The judgment recognizes that the patient and family’s religious beliefs are important factors to consider in these decisions.
“Nevertheless, the dissenting opinion gives cause for concern, in that it recognizes the importance of religious beliefs and personal values in these situations, but then says the doctors’ professional opinions should have priority.”
Writing for the majority on the bench, Chief Justice Beverley MacLachlin upheld the decision of two lower courts rejecting the doctors’ position. The doctors argued withdrawing life-sustaining measures did not require consent from Rasouli’s wife, his surrogate decision-maker, because they asserted that discontinuing care did not constitute “treatment” as set out under Ontario’s law. For the same reason, the doctors said, they did not require permission from the province’s Consent and Capacity Board to end care.
“While the end-of-life context poses difficult ethical dilemmas for physicians, this does not alter the conclusion that withdrawal of life support constitutes treatment requiring consent under the HCCA (Health Care Consent Act),” MacLachlin wrote.
Dilemmas in end-of-life care are “inherent to medical practice,” MacLachlin said, and should not undermine provisions set out in the Act that clearly provide for a “meaningful role” for family and surrogate decision-makers in providing consent for treatment, including the discontinuation of life-prolonging measures and the beginning of palliative care.
Rasouli, a retired engineer, became comatose after undergoing brain surgery for a benign tumour in 2010. His attending physicians at Sunnybrook hospital gave him a poor prognosis with little chance of meaningful recovery from the coma, although his diagnosis was later upgraded from “vegetative” to “minimally conscious.”
Press release from Euthanasia Prevention Coalition
Catholic Civil Rights League (www.ccrl.ca) assists in creating conditions within which Catholic teachings can be better understood, cooperates with other organizations in defending civil rights in Canada, and opposes defamation and discrimination against Catholics on the basis of their beliefs. CCRL was founded in 1985 as an independent lay organization and has chapters across Canada. The Catholic Civil Rights League is a Canadian non-profit organization entirely supported by the generosity of its members.
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