Legal risk in witholding treatment
Doctors are at risk of breaking the law when they withhold life-sustaining treatment such as cardiopulmonary resuscitation (CPR) from older people who have lost the ability to make their own decisions, according to two Queensland legal academics.
Dr Ben White and Professor Lindy Willmott from Queensland University of Technology (QUT) say 13,000 older people who can’t make such decisions die each year in Queensland, New South Wales and Victoria, after treatment has been witheld.
The academics are now embarking on a $287,000 Australian Research Council Linkage project to investigate doctors’ understanding of the legal requirements around end-of-life decisions.
“In Queensland, consent to withhold medical treatment is required by law for people who cannot make decisions for themselves, even if the doctors think that resuscitation will not help the patient or if treating them is going to be futile,” Dr White said.
“Consent to withhold treatment such as resuscitation can be obtained in a number of ways. For example, a patient might have an advance health directive that refuses the treatment or they might have appointed someone under an enduring power of attorney to make this decision”.
“If there aren’t any formal legal arrangements like these in place, the law generally recognises the decision of a family member or other person who is close to the patient as a ‘statutory health attorney’,” he said.
Dr White said doctors and hospitals needed to know what the law was in this area because anecdotal evidence suggested their knowledge was lacking.
He added that hospitals need to make sure their policies reflect the law in this area and support doctors who make lawful decisions. Professor Willmott said the state of the nature of the law in this area contributed to doctors’ ignorance.
“The law is complex and uncertain in this area so we will critically analyse the current law to suggest reforms to advance patients’ autonomy and dignity, and to protect vulnerable adults from inappropriate treatment decisions,” Professor Willmott said.
“Clarity and consistency of laws in this area could also help reduce health costs for the community by helping doctors avoid litigation”.
