Moira McQueen, director of the Toronto-based Canadian Catholic Bioethics Institute, welcomed the ruling.

Court ruling reaffirms family rights in end-of-life care conflict

By 
  • July 4, 2011

TORONTO - An Ontario Court of Appeal ruling that makes it harder for doctors to withdraw life support when such a decision goes against a patient's family's wishes is "fabulous" news to the Euthanasia Prevention Coalition.

Alex Schadenberg, executive director of the coalition, said the June 29 ruling in the case of Hassan Rasouli was exactly what the coalition was hoping for.

"Doctors were interpreting their power as being that they could withdraw treatment without consent and that they only required consent to treat," said Schadenberg.

The withdrawal of life support now requires the consent of a substitute decision maker — and if that's not satisfactory to the doctor, he or she must go to the provincial Consent and Capacity Board to try to have the decision overturned, said Toronto lawyer Gardner Hodder, who represented the Rasouli family.

The case was initiated when Rasouli's doctors, Brian Cuthbertson and Gordon Rubenfeld of Toronto's Sunnybrook Hospital, wanted to take him off life support against the wishes of his family. They concluded that Rasouli is in a permanent vegetative state and will never regain consciousness. However, Rasouli's wife and substitute decision maker, Parichehr Salasel, did not accept the doctors' prognosis.

"I think (the ruling) confirms what most people and certainly what I thought was the case anyway," said Hodder. "That to withdraw life support a physician would need either consent or a court ruling or a ruling of somebody."

Simply put, Schadenberg said the ruling means families won't have to worry about a doctor telling them their opinion doesn't matter.

And, for the most part, end-of-life issues affect people of a faith background because they have hope, added Schadenberg.

"The Rasoulis said we believe in giving him more of a chance," he said. "We believe he's not dead yet and we believe he's getting better…We have faith that maybe something is going to happen here. And I think these situations should be respected."

Moira McQueen, director of the Toronto-based Canadian Catholic Bioethics Institute, said it's reassuring that doctors will be obliged to seek consent from a substitute decision maker.

"The Rasouli case points back to the idea that of course families have rights too and doctors or medical personnel cannot override those rights if there's a clear disagreement, unless there's an emergency," said McQueen.

The basic moral issue at work is that patients have a moral right to evaluate their own treatment — as do their substitute decision makers if they're not able to, said McQueen.

"They have a moral and legal right to be able to go to great lengths to be able to consult both medical and spiritual advisors… to help them clarify the situation for themselves to assure the decision they're coming to is a good one."

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