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End Of Life |
Enforcing your wishes with an advance care directive |
End-of-life issues are currently being discussed in the media here and overseas. They were highlighted by a recent case in NSW where a patient had made an 'advance health care directive' which recorded his wish to avoid certain treatments aimed at prolonging life. |
An advance health care directive is a document that states your wishes or directions regarding your future health care for various medical conditions. It comes into effect only at a stage when you are unable to make your own decisions. You may wish the directive to apply at any time when you are unable to decide for yourself, or you may want it to apply only if you are terminally ill. |
In the NSW case, a patient was being kept alive by mechanical ventilation and kidney dialysis. |
When the health service became aware of the existence of an advance care directive refusing dialysis treatment, it sought legal clarification on whether the directive was valid, and whether the health service would be justified in complying with the person's wishes. |
The courts held that in general "whenever there is a conflict between a capable adult's exercise of the right of self-determination and the state's interest in preserving life, the right of the individual must prevail", although there may be exceptions to that principle. |
The hospital was required to give effect to the advance care directive, even though withdrawal of dialysis would hasten the person's death. |
