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The Forum > Article Comments > Withdrawing life support - supporting the judge's decision > Comments

Withdrawing life support - supporting the judge's decision : Comments

By Ben White and Lindy Willmott, published 24/11/2004

Ben White and Lindy Willmott argue that the judge made the right decision in the Messiha case.

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A very good article that balances my opinion with the worthy point of view that futile treatment is not necessarily in the best interests of the patient. What I would emphasise is the danger of allowing the medical profession the last word on futile treatment over and above the interests of the family. Remember that while the court in the Messiha case made a disclaimer, saying they weren't ignoring the arguments of the family members, it basically did so, leaving the ultimate question to medical opinion, more so than in many other Australian cases. I guess the argument comes down to whether we are comfortable with the medical profession assessing the best time to withdraw treatment and having faith that hospitals will execute their policies of consultation with family members in an adequate way. For if similar cases in the Messiha category come before the courts, we know very well which way it will be decided.
Posted by Alex Perrottet, Thursday, 25 November 2004 8:40:59 AM
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I'd have to agree with Alex: is it up to the medical doctors when to keep someone alive and when to let them go? Will we see more and more cases where doctors, having been granted these precedents in the past, can make the decision on their own without regard for the family's wishes? A number of cases have been reported in the Netherlands, for example, where the doctor would come into the room, ask the patient's family to step out, and when they're asked to come back in, the patient is dead. Of course, the doctor is only acting on the patient's best interests, according to his own judgement.

Will this scenario become more and more common and acceptable to society? Is this how it should be?
Posted by Jeff, Thursday, 25 November 2004 11:24:18 AM
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I agree with Alex in his assessment of the article. However, as a total layman, I would like to pose the question:
Why is legal for doctors to terminate treatment or turn off life support, but it is illegal to provide euthenasia assistance to terminally ill patients, at their request? In either case, the ultimate outcome is death. In the case of euthenasia, the patient is terminally ill - s/he WILL die.

As I stated, I am a layman, so my question may seem obvious to the experts. But I would appreciate clarification and comments by others.

Thank you

Michele
Posted by mcertl, Thursday, 25 November 2004 2:45:05 PM
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This is a response to Micheleís question above. Firstly, your question is not just a laymanís question. There are many academics, students and members of the medical profession who ask the same question, and of course there is a lot of debate about the differences in the two scenarios you describe.

Euthanasia is illegal because it is the wilful taking of the life of another person, which is murder, with or without the consent of the patient / victim. Euthanasia can involve many different acts or omissions, and one of them is the removal of life support, in the case that the life support is not burdensome or futile and is in the best interests of the patient. Therefore, the illegal act of euthanasia is distinguished from cases where doctors can legally remove life support if it is considered futile, as in Isaac Messihaís situation. In these cases, it is the underlying disease or illness that has clearly caused the death, not the doctor who flicks the switch.

Itís important not to be confused about separate acts because their outcomes are both the same. If I am a cancer patient, I might die next week from cancer, but I might die even sooner if someone walks in and kills me. The outcome is the same, but the immediate cause of death is totally different.

Furthermore, in criminal law, elements of an offence include the physical act, as well as the mental intention. If the intention is not proved, there is no crime. Thus, the doctorís intention becomes important ie; whether he or she intends to kill the patient, or whether he or she wishes to administer pain-relieving treatment which may hasten death as a side-effect. Once again the outcome is the same, yet the act in the former case is legally and morally wrong.

Itís a difficult area of course, but I hope Iíve outlined some key points that might help you.
Posted by Alex Perrottet, Thursday, 25 November 2004 7:15:41 PM
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Alex,

Thank you for making me feel less "lay". My forte lies in languages and property/estate management, hence the my calling myself a 'layman on medical issues.

In response to your explanation - I am (still) confused. You say:

Furthermore, in criminal law, elements of an offence include the physical act, as well as the mental intention. If the intention is not proved, there is no crime. Thus, the doctorís intention becomes important ie; whether he or she intends to kill the patient, or whether he or she wishes to administer pain-relieving treatment which may hasten death as a side-effect. Once again the outcome is the same, yet the act in the former case is legally and morally wrong.

Ok, when a person is assisting in euthansia, it is usually with the intention of administering pain-relieving treatment which may hasten death as a side-effect, not with the intention to kill/murder.

To me, the act of removing life support because it is futile can be argued in both a cse, where the patient is in a coma (Isaac Messiha) or where the person cannot "live" without it. As amatter of fact in the case where the person cannot live without it and asks for "release", I would think it would be even more humane to assist.

However, eventhough I am pro-euthanasia (how could one guess?), I do accept that currently it is still illegal.

Thank you for your explanation, it did clarify a couple of points I was not aware of.

Regards

Michele
Posted by mcertl, Friday, 26 November 2004 9:26:13 AM
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I'd recently read something shocking about the Terry Schiavo case in Florida, USA. Her husband, who has legal custody of the brain-damaged wife, wishes to end her life by withholding food from her. She does not need any life support other than food and fluids.

The patient is NOT currently in pain. She can respond to stimuli and has not received therapy since 1991, prior to which she had actually recovered from coma and had responded to early therapy. The husband wishes to end her life to avoid alleged psychological pain on the part of the patient. The "exit program" for her, written out by doctors, included pain medication, since starving her to death would be very painful.

This has absolutely nothing to do with Isaac Messiha's case of course.

Or does it? I wonder how many steps there are between ending the life of a comatose patient, to ending the life of a non-comatose patient, both against parental consent. Not directly questioning the decision of the court in Messiha's case, I can't help but wonder how our attitudes towards human life affects those sorts of decisions, and how far we have to go before dismissing human life to death all too quickly.
Posted by Jeff, Monday, 29 November 2004 5:54:31 PM
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