Food and water is basic care, not medical intervention: British Columbia Supreme Court

“Withdrawing oral nutrition and hydration for an adult that is not capable of making that decision would constitute neglect,” the justice wrote.
Tue Feb 4, 2014 - 4:39 pm EST

Vancouver, B.C., February 4, 2014 ( – A British Columbia court has ruled that food and water is basic care and so cannot be withdrawn as though it were an extraordinary medical intervention.

In a decision issued Monday, Justice Greyell of the Supreme Court of British Columbia ruled the nursing home where Alzheimer patient Margaret Bentley resides would be guilty of neglect were it to follow Bentley’s 1991 living will.

“Withdrawing oral nutrition and hydration for an adult that is not capable of making that decision would constitute neglect within the meaning of the Adult Guardianship Act,” he wrote.

Bentley’s family sought a declaration from the court that she “not be given nourishment or liquids,” asserting that she had “expressed strong wishes while she was mentally capable that she did not want to be given nourishment or liquids in her current condition,” the court documents stated.

Bentley, who is 82, is a patient at Maplewood Care, an elderly care facility in Abbotsford. The facility was among the parties opposing the family’s legal action. There she is being spoon- and cup-fed, but is not being force-fed.

Expert opinion heeded by the court determined that Bentley is at an advanced stage of Alzheimer’s, but is not, in fact, dying as a result of the disease. Because of this, the judge determined that the withdrawal of nourishment would be the cause of her death, and therefore illegal.

“Even if Mrs. Bentley was found incapable of making the decision to accept oral nutrition and hydration, I am not satisfied that the British Columbia legislature intended to allow reference to previously expressed wishes … to be relied on to refuse basic personal care that is necessary to preserve life,” Justice Greyell wrote.

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, was pleased with the verdict. Had the judge found otherwise, he said, it would have had far-reaching, negative consequences for the elderly. Schadenberg suggested that perhaps as many as 20 percent of patients in nursing homes require some kind of assistance in eating. To fail to feed patients because it is deemed ‘medical treatment,’ and therefore dispensable, would lead to “euthanasia by omission,” he said.

Schadenberg also drew attention to the remark by Mrs. Bentley’s daughter, who is a nurse, that this practice of depriving nourishment in cases like her mother’s is going on everywhere. “If so,” Schadenberg said, “what she is saying is that neglect is going on everywhere. … The issue of neglect is serious. Hopefully this court decision will affect attitudes towards neglecting our seniors.”

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