Disputes Over Withdrawal of End of Life Treatment
The Supreme Court of Canada has just released the decision in Cuthbertson v. Rasouli, clarifying the steps health care practitioners should take when there is a dispute with a substitute decision maker over the withdrawal of life support:
1. The health practitioner determines whether in his view continuance of life support is medically indicated for the patient;
2. If the health practitioner determines that continuance of life support is no longer medically indicated for the patient, he advises the patient’s substitute decision-maker and seeks her consent to withdraw the treatment;
3. The substitute decision-maker gives or refuses consent in accordance with the applicable prior wishes of the incapable person, or in the absence of such wishes on the basis of the best interests of the patient, having regard to the specified factors in s. 21(2) of the HCCA;
4. If the substitute decision-maker consents, the health practitioner withdraws life support;
5. If the substitute decision-maker refuses consent to withdrawal of life support, the health practitioner may challenge the substitute decision-maker’s refusal by applying to the Consent and Capacity Board: s. 37;
6. If the Board finds that the refusal to provide consent to the withdrawal of life support was not in accordance with the requirements of the HCCA, it may substitute its own decision for that of the substitute decision-maker, and permit withdrawal of life support.
See discussion of the decision on Slaw.