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The Right to Refuse Treatment and Natural Death Legislation

Published online by Cambridge University Press:  01 January 2021

Jane A. Raible
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Extract

A great deal of discussion and debate has centered around the right of a terminally ill patient to refuse life-sustaining treatment. The statement of policy found in Idaho's recent Natural Death Act summarizes many of these issues:

The legislature finds that adult persons have a fundamental right to control decisions relating to the rendering of their medical care, including the decisions to have life sustaining procedures withheld or withdrawn in instances of a terminal condition.

The legislature further finds that modern medical technology has made possible the artificial prolongation of human life beyond natural limits.

The legislature further finds that patients suffering from terminal conditions are sometimes unable to express their desire to withhold or withdraw such artificial life prolongation procedures because of the progress of the disease process which renders the patient comatose or unable to communicate with the physician.

Type
Article
Information
Medicolegal News , Volume 5 , Issue 4 , Fall 1977 , pp. 6 - 13
Copyright
Copyright © American Society of Law, Medicine and Ethics 1977

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Footnotes

*

Executive Director, the Northwest Institute of Ethics and the Life Sciences, seattle, Washington, Member of the faculty (Ethics in Science), The Evergreen State College, Olympia, Washington; member, Human Research Review Board, State of Washington; adjunct faculty at San Francisco Theological Seminary and the University of Alaska

References

Idaho S.B. 1164, enacted March 1977. See Idaho Session Laws, new c.45, title 39 (especially Sec. 39–4502).Google Scholar
Memorandum relative to House Bill 252 to the Office of the Secretary of State from Carol A. Smith, Assistant Attorney General of the State of Washington, dated February 4, 1977. This opinion was earlier stated in a memorandum from Wayne L. Williams, Assistant Attorney General of the State of Washington, to the Secretary of State, dated February 13, 1973, relative to an earlier draft of a natural death act (S.B. 2449).Google Scholar
California Health and Safety Code, Part I of Division 7, c. 3.9:7187e.Google Scholar
California Health and Safety Code, Part I of Division 7, c. 3.9:7191c.Google Scholar
It is interesting to note that at the time of enactment of this requirement, there existed no state ombudsman.Google Scholar
New Mexico S.B. 16, c. 287 Sec. 56 (enacted April 1977).Google Scholar
The Pope Speaks, 3–4 (1956–58): 393–98. Speaking specifically to the case of prolongation of life by use of resuscitation, Pope Pius XII stated: Normally one is held to use ordinary means — according to circumstances of persons, places, times and culture — that is to say, means that do not involve any grave burden for oneself or another. A more strict obligation would be too burdensome for most men and would render the attainment of the higher, more important good too difficult. … Therefore, the patient, if he were capable of making a personal decision, could lawfully use if [resuscitation] and consequently, give the doctor permission to use it. On the other hand, since these forms of treatment go beyond the ordinary means to which one is bound, it cannot be held that there is an obligation to use them nor, consequently, that one is bound to give the doctor permission to use them.Google Scholar
See generally, New England Journal of Medicine 295:7 (August 12, 1976) (collection of articles on critical care review committees).10.1056/NEJM197609162951228CrossRefGoogle Scholar
It is of interest that the Canadian Medical Association's Guide for Ethical Conduct of a physician has carefully stated that pronouncement of death should not be made by a physician who has a vested interest in transplantation in that facility. This writer suggests that natural death legislation should specifically prohibit such physicians from corroboration of a terminally ill diagnosis out of the same concern; a possible conflict of interests.Google Scholar