TORONTO, May 24, 2013 ( – A Toronto hospital has issued a “do not resuscitate” for a 73-year-old man who told his son, “Don't let me die.”

Joaquim Silva Rodrigues was diagnosed with progressive supranuclear palsy, a rare neurodegenerative disease similar to Parkinson’s Disease.

He is currently unconscious but breathing unassisted and not in immanent danger of dying.

Rodrigues' son, Roger Rodrigues, who has power of attorney, said his father had left instructions with his family that, though there is no known treatment for the disease, he didn't want to be left to die.


At a hearing of the Consent and Capacity Board, the provincial agency that mediates and issues rulings on end-of-life-care disputes, Roger said his father told him, “Don’t let me die. Stop it from progressing…If that doesn’t work, don’t let them kill me.”

However, the family says it discovered that on May 14, doctors at Sunnybrook had placed a “do not resuscitate” order on Rodrigues’s medical chart, with the explanation that he has “no reasonable hope of recovery or improvement.”

Since he's been in the hospital, Rodrigues has been placed on a ventilator three times. But the doctors have decided, without consulting the family, that should he require the ventilator again, they would refuse life-saving treatment.

Sunnybrook's Dr. Andre Amaral responded that since Rodrigues “has no chances of recovery,” prolonging his life would not only be futile, but that Rodrigues' life may not be worth living.

“There’s no clear benefit in prolonging life when you cannot tell whether the life that’s being prolonged is actually worth living for,” Amaral reportedly told the panel. “We’re prolonging life for suffering and pain.”

Sunnybrook’s chief medical executive, Dr. Keith Rose, supported Amaral's decision, saying, “The final decision-making, after all steps have been gone through and discussions with the family, then, if it’s in the best interest of the patient, it is the physicians’ decision to make.”

The question of whether doctors have the right to make these decisions, however, is currently before the Supreme Court of Canada, which is considering the case of Hasan Rasouli, another Sunnybrook patient whose family fought for his life after doctors decided to withdraw all life-sustaining interventions – including ventilation, hydration, and nutrition – from the comatose man.

“Similar to the Rasouli case, Sunnybrook hospital is imposing a decision to withhold treatment from Joaquim Rodrigues against the wishes of the family,” said Alex Schadenberg, executive director of the Euthanasia Prevention Coalition.

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“The decision to withhold ventilator support from a person is really inhumane,” Schadenberg told “Mr. Rodrigues would die, possibly slowly, gasping for air,” he explained.

Schadenberg noted that since doctors in Ontario cannot be forced to provide medical treatment that is deemed futile, “it is therefore incumbent upon Sunnybrook hospital to achieve an agreement with families rather than continue with their aggressive approach to treatment decisions.”

“If Mr. Rodrigues wanted to have the ventilator withdrawn or withheld, the hospital would quickly comply with the request,” Schadenberg said. “The hospital should equally comply when a person wishes to have the ventilator continued or an option. Otherwise we are forcing people to die an undignified death, a death that is similar to an asphyxiation.”

New research into the consciousness of comatose patients, in what is described as a Persistent Vegetative State (PVS), has found that while they may show no signs of physical activity, their mental activity and awareness of external stimuli may be very much intact.

Researchers from the Brain and Mind Institute at the University of Western Ontario have developed a brainwave-reading technology that can simply and cost-effectively assess the consciousness of PVS patients.

By analyzing brainwaves through a functional magnetic resonance imaging machine (fMRI), researchers were able to communicate with patients who seemed to be entirely unresponsive to the outside world, but were able to signal that they were, in fact, conscious by changing their patterns of brain activity.

A case in point is that of Scott Routley, who was considered to be beyond communication. Routley was able to communicate to a research team that he was not in pain.

Lead researcher Dr. Adrian Owen called the communication with Routley a “landmark moment,” saying that “for the first time, a patient can actually tell us information, important information, about how they’re feeling and their current situation.”

Dr. Owen explained that when the patient was told to imagine doing certain activities, the MRI scanner immediately picked up that specific activity in his brain.

“[F]or example, we ask him to imagine using his arms. Scott is unable to use his arms in reality, but it turns out he is perfectly able to imagine moving his arms,” he said.