Life’s fatal

September 22, 2009

An Australian man who won a court case allowing him to refuse food and water has died.

Rossiter, who broke his spine in 2004 in a road accident and was left a spastic quadriplegic after a fall last year, had described his life as “a living hell”.

In mid-August, the Australian state Supreme Court ruled that Rossiter’s nursing home in the west coast city of Perth must respect his decision to starve to death. . .

         The case shed light on a gray area in Australian law: patients have a right to refuse lifesaving treatment but helping   another to commit suicide is a crime punishable by life in prison.

Some may feel the law is dancing on the head of a pin here, but there is a significant difference between killing people and withdrawing, or not giving in the first place, treatment which allows them to die.

Macdoctor discussed this in  To treat or not to treat :

One last comment. The withdrawal of pointless treatment from a patient has been described as “medical euthanasia” or “passive euthanasia”. I don’t believe for a second that this has anything to do with euthanasia at all. Euthanasia is the active termination of the life of a person. In this country it is also known as murder. The passive termination of a life by letting nature take its course has another name. It is called death.

I have twice been asked to make the decision on whether or not treatment should be given for my sons.

Both had brain disorders. The first, Tom, was just 20 weeks old. He hadn’t passed any of the developmental milestones and had spent nearly a third of his life in hospital.

When he stopped breathing in the middle of the night we revived him and went in to Oamaru Hospital where the doctor asked us how aggressive we wanted to be in treating him.

We said if it came down to treatment which was only delaying his inevitable death we’d prefer to leave him be. He was transferred to Dunedin Hospital where a medical team spent a considerable amount of time trying to help him. Finally, the senior doctor turned to me and repeated the question we’d been asked in Oamaru.

I gave the same answer and a few minutes later, Tom stopped breathing.

Seven years later I faced a similar decision over our second son. Dan had a brain disorder and he too had passed none of the developmental milestones. He was five but could do no more than a new born baby. He had a hernia and reflux which required surgery. He contracted an infection a few days later and stopped breathing.

The doctor was going to summon the crash team but I told him Dan’s paediatrician had advised us if something like this happened we should leave him be. The doctor asked me if that’s what I wanted and I said yes.

These cases are different from that of the Australian man, but the principle of the right to refuse treatment, yourself or on behalf of your next of kin, is the same.

Life expectancy has increased and so to have our expectations of medical treatment. But there are limits to what health professionals can and should do because life is fatal.

One of the guiding principles in medicine is first do no harm. Sometimes letting nature take its course so people die, with the physical and emotional support they need to make it as painless as possible, is the best way to do that.

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