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As we age: What’s life, what’s living?
By Graham Hookey
It was just a couple of months ago that I wrote about the Margaret Bentley case, in which her family was going to court in order to try and impose her wishes to be allowed to pass with dignity – through denial of feeding if necessary – once she reached a stage of Alzheimer’s that, for all intents and purposes, has taken her from her family in every way except as a living biological entity.
The Bentley case is about giving an individual the right to set the parameters around the quality of their living and, thus, to direct the medical community to allow specific treatment.
Last week, in a decision by the Supreme Court of Canada, it was determined that doctors should not have the right to make choices when it comes to removing life support systems from those who cannot make a decision themselves, without permission from the family.
It brought to light, the opposite angle of the Bentley situation. In one case, a family is fighting to let a loved one go, and in the other, a family is fighting to keep a loved one alive.
The case of Hassan Rasouli offered much food for thought in the field of end-of-life decision-making.
Mr. Rasouli suffered catastrophic brain damage after a brain operation that resulted in an infection. He has been in a vegetative state for three years. His doctors asserted that he will never be communicative and that the procedures he had to be put through, in order to force feed him, were akin to torture.
Consistent with the medical oath to ‘do no harm,’ the doctors wanted to withdraw such procedures.
The family, firm in the belief that Mr. Rasouli was still aware of what was going on around him, and still with them, refused permission to remove life supports.
If Mrs. Bentley was in the same position as Mr. Rasouli, that is she had to be forced fed, then her living will would likely have been respected. In other words, her desire not to be kept on life support systems would have resulted in their withdrawal. After all, it is neither the choice of her family, nor the doctors, to end her life. It would be deemed as her choice.
In Mr. Rasouli’s case, with no direction from him personally, the right to make a decision by either his family or the medical community became much more complicated, and the Supreme Court supported the notion that the right of the individual to life, with no medically imposed valuation of the quality of that life, is the dominant factor to be considered when there is disagreement.
It is, yet again, a reminder to us all that if we feel strongly about such end-of-life matters, and the effects upon us and our family, we need to leave some very clear instructions to be followed in the event of a catastrophe.