Doctors who ignore living wills ‘breaching’ patients’ rights

DOCTORS who ignore a ‘living will’ by forcing a patient to receive life-saving care against their wishes could potentially be taking part in medical assault, it has been claimed.

Speaking at the Irish Hospital Consultants Association annual conference in Cavan, senior counsel Oonah McCrann said that despite the need to protect a life, if a doctor deliberately went against a patient’s request not to receive care they could be in breach of the individual’s rights.

The comment was made just two days after a British coroner’s court found that hospital staff acted within the law when they allowed a young woman who attempted suicide to die as she had insisted they should not revive her.

The request was made in a living will, also known as an advance care directive, in which the 26-year-old woman specifically said she did not want to be revived. While not referring to the case, Ms McCrann said patients had a right to turn down treatment once they were fully aware of the likely implications.

However, she added that detailed legislation was needed to take away the potential legal risk to doctors over the matter.

“If there’s going to be a real and meaningful approach to medical care then, while a doctor is entitled to medical and ethical views, they are not entitled to impose them on a patient. A doctor cannot have a legal right to not follow an advance care directive,” said the senior counsel.

“Legislation should be brought forward to protect individual’s right to consent and reject.

Dr Shaun O’Keeffe, consultant geriatrician at University College Hospital Galway, said while living wills were beneficial to some patients, doctors who receive them are left to make complex decisions over care in a short period of time.

Brian Lamont, a consultant anaesthetist at Beaumont Hospital, added that in some cases the wider use of advance directives was of significant benefit to the patient.

Highlighting an incident in recent weeks, the physician said that an 85-year-old woman had been brought to the hospital after falling.

She was suffering from severe head injuries and had been placed on a ventilator in order to survive until her family told the geriatrician treating her that she had expressly stated she did not want to be kept alive on a machine if there was no other way to survive.

“The geriatrician made a decision, said take the tube out of that lady.

“There’s politicians out there who want to just package this away but it’s a very complex issue,” he said.