A model for decision-making at the end-of-life : Queensland and beyond

Willmott, Lindy & White, Benjamin P. (2006) A model for decision-making at the end-of-life : Queensland and beyond. Medicine and Law, 25(1), pp. 201-217.

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A decision to allow a patient's life to end by withdrawing or withholding medical treatment can be extremely difficult. In addition to making the appropriate medical and ethical judgments, there are also legal considerations to take into account, the most important of which is ensuring that the death is lawful. This paper addresses when it is legal to withdraw or withhold medical treatment that is needed to keep a patient alive. It draws on cases and legislation from the common law world (including Australia, England and New Zealand) and considers the various legal tests applied in the different jurisdictions -- Two of the most common tests employed in this situation are the "best interests of the patient" test and the "substituted judgment" test. Some jurisdictions also include other criteria as well, such as a requirement that withdrawing or withholding of medical treatment is "not inconsistent with good medical practice". This paper analyses these different legal tests, and after identifying the factors that are judged to be legally relevant to consider when deciding to withdraw or withhold treatment, outlines a preferred model. This model addresses who the relevant decision maker should be, and the criteria that should govern their decision. It suggests that family members are better equipped and more appropriate to act as decision makers than health professionals, and also questions the appropriateness of responsible medical opinion as the decisive factor in such cases, preferring instead an approach more consistent with the principles of self determination. The model also proposes a method for resolving any disputes that arise.

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ID Code: 17514
Item Type: Journal Article
Refereed: Yes
Additional Information: Access to the author-version is currently restricted pending permission from the publisher. For more information, please refer to the journal’s website (see hypertext link) or contact the author.
Keywords: End of life decision-making, Withholding or withdrawing life-sustaining medical treatment, Adult guardianship law
ISSN: 0723-1393
Subjects: Australian and New Zealand Standard Research Classification > LAW AND LEGAL STUDIES (180000) > LAW (180100)
Australian and New Zealand Standard Research Classification > LAW AND LEGAL STUDIES (180000) > LAW (180100) > Law and Society (180119)
Divisions: Current > QUT Faculties and Divisions > Faculty of Law
Current > Research Centres > Australian Centre for Health Law Research
Current > Schools > School of Law
Copyright Owner: Copyright 2006 International Center for Health, Law and Medicine
Deposited On: 05 Feb 2009 22:21
Last Modified: 06 Mar 2015 01:24

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