The Globe and Mail, one of Canada’s national newspapers, published an editorial last week entitled: The Supreme Court is right to hear life-support case.
The Rasouli case asks the question - who has the right to decide to withdraw medical treatment? Dr Brian Cuthbertson and Dr Gordon Rubenfeld at Sunnybrook hospital are arguing that they have the unilateral right to decide when medical treatment can be withdrawn, while the court decision by Justice Himel and the unanimous decision of the Ontario Court of Appeal decided that doctors must first obtain consent before withdrawing life-sustaining treatment, such as in this case, the ventilator.
The Euthanasia Prevention Coalition (EPC) successfully intervened in the Rasouli case at the Ontario Court of Appeal.
In their editorial, the Globe and Mail stated that the Rasouli case is not an ideal case due to the shifting medical facts with regards to Hassan Rasouli, but the Globe and Mail contends that the Supreme Court of Canada needs to provide guidance concerning end-of-life treatment.
The Globe and Mail editorial then states:
The issue – who decides – has been a divisive, emotional one. Giving doctors unilateral decision-making power seems extreme, yet it is equally perverse for families of incapable patients to insist upon costly interventions of no medical benefit and some potential harm.
The absence of direction has left a policy vacuum, and potentially treatment vacuums in Canadian hospitals. Will physicians hesitate to start trials of therapy in critically ill patients if they think they cannot withdraw them when later deemed futile?
For more information on the Rasouli case click here.
EPC disagrees with the Globe an Mail editorial. We are convinced that the decision by the three judge panel of the Ontario Court of Appeal was balanced and offered the best possible guidance that the court could provide.
It is important to note that this case is not related to end-of-life treatment decisions, as stated by the Globe and Mail editorial but rather life-sustaining treatment decisions. Some people are dependent on medical treatment, but not otherwise dying.
It is also important to recognize that the Rasouli decision is not limited to ventilator cases. The definition of medical treatment, and even life-sustaining medical treatment includes artificially providing fluids and food, do not resuscitate decisions, and more.
Link to the EPC response to the Rasouli decision by the Ontario Court of Appeal.
The Ontario Court of Appeal decision was not perfect, but very balanced. It found that doctors could unilaterally withdraw treatments that were providing no benefit, treatments that are physiologically futile, but life-sustaining treatments, such as the ventilator, were not without benefit, in fact the ventilator was effectively accomplishing exactly what it was designed to accomplish.
Since the Rasouli family and the doctors were unable to achieve an agreement, therefore the Ontario Court of Appeal agreed with Justice Himel that the case should be referred to the Ontario Consent and Capacity Board, an government body that was established to decide when medical treatment disputes occur.
If the Supreme Court of Canada grants doctors the unilateral right to decide, then the deeply held values of many Canadians will become unimportant. The doctors are asking that they have the right to decide whether or not they believe the medical treatment is futile.
Let’s remember, Hassan Rasouli was wrongly diagnosed as being in a persistent vegetative state, a state that the doctors claim was permanent. Mr Rasouli is now diagnosed as not being PVS, which is exactly as his wife, who was a practising physician before moving to Canada, had contended from the beginning.
The decision of the Ontario Court of Appeal should be upheld by the Supreme Court of Canada.
The EPC is seeking intervening standing in the Rasouli case at the Supreme Court of Canada.