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Report No. 196

So far as Medical Care at the end of life is concerned, Sopinka J surveyed the Canadian position as follows:

"Medical Care at the end of life: Canadian Courts have recognized a common law right of patients to refuse consent to medical treatment, or to demand that treatment, once commenced, be withdrawn or discontinued (Ciarlarielle vs. Schacter: 1993(2) S.C. R 119). This right has been specifically recognized to exist even if the withdrawal or refusal of treatment may result in death (Nancy B vs. Hotel-Dieu de Quebec (1992) 86 DLR (4th ) 385 (Que. S.C.); and Mallette vs. Shulman (1990) 72. O.R. (2d) 417 (CA).

The United States Supreme Court has also recently recognized that the right to refuse lifesustaining medical treatment is an aspect of the liberty interest protected by the Fourteenth Amendment in Cruzan vs. Director Missori Health Dept (1990) III L. Ed 2d 224., However, that Court also enunciated the view that when a patient was unconscious and thus unable to express her own view, the State was justified in requiring compelling evidence that withdrawal of treatment was, in fact, what the patient would have requested, had she been competent.

The House of Lords has also had occasion very recently to address the matter of withdrawal of treatment. In Airedale NHS Trust vs. Bland 1993(2) WLR 316, their Lordships authorized the withdrawal of artificial feeding from a 17 year-old boy who was in a persistent vegetative state as a result of injuries suffered in soccer riots, upon the consent of his parents. Persistence in a vegetative state was found not to be beneficial to the patient and the principle of sanctity of life, which was not absolute, was therefore, found not to be violated by the withdrawal of treatment.

Although the issue was not before them, their Lordships nevertheless commented on the distinction between withdrawal of treatment and active euthanasia. Lord Keith stated (at p 362) that though the principle of sanctity of life is not an absolute one, 'it forbids the taking of active measures to cut short the life of a terminally ill patient. Lord Goff also emphasized this distinction, stressing that the law draws a crucial distinction between active and passive euthanasia."

Medical Treatment to Terminally Ill Patients (Protection of Patients and Medical Practitioners) Back

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