Adult refusal of medical treatment
On The Agenda
A patient, who understands the nature, purpose and effects of proposed medical treatment, has the capacity to refuse that treatment, even if his general capacity is impaired by chronic mental illness. The High Court has jurisdiction to grant injunctive relief relating to future medical treatment. Mr Justice Thorpe granted an injunction preventing Heatherwood Hospital, Ascot, from giving C an amputation now or in the future without C's express written consent. C, now aged 68, was serving a seven-year prison sentence in when he was diagnosed as mentally ill and transferred to Broadmoor. In September , he was diagnosed with gangrene in the right foot and it was considered C would die if the leg was not amputated below the knee and that C's chances of survival with conservative treatment would be no better than 15 per cent.
Re T (Adult: Refusal of Medical Treatment)
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Do Patients Have the Right to Refuse Treatment?
The patient had a condition caused by malformation of blood vessels in the spinal cord. She executed a living will stating that if she were unable to give instructions she wished for treatment to be withdrawn if she was suffering from a life-threatening condition, permanent mental impairment or permanent unconsciousness. She eventually became tetraplegic, suddenly suffering complete paralysis from the neck down. When she began to experience respiratory problems, the intensive care team in the hospital treated her with a ventilator, upon which she is now dependent. The doctors considered that the terms of the living will were not specific enough to authorise withdrawal of the ventilation. She underwent surgery, which gave her some movement of the head, and the ability to articulate words.
Re S (Adult: Refusal of Medical Treatment)
KIE: The English Court of Appeal, Civil Division, denied an appeal on behalf of a critically ill, unconscious woman who had been given a blood transfusion upon court order after having previously refused to consent to one. The woman's mother, a Jehovah's Witness, had apparently influenced the decision of the daughter, who was not a Jehovah's Witness. The Court of Appeal held that, though every adult has the right and capacity to refuse medical treatment, this presumption of capacity can be overridden upon a determination that factors such as confusion, unconsciousness, fatigue, or shock affect the patient's decision. When a patient refuses treatment, doctors must consider the importance of the treatment, and whether the patient's capacity was reduced.
Most, but not all, Americans have the right to refuse medical treatment. However, there are three exceptions to the right to refuse treatment. They occur when others are subsidizing the patient's income during his or her period of injury, sickness and inability to work. In most of these cases, a patient may not refuse treatment if doing so will extend his time away from work and his ability to support himself.
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