Decision adds context to SCC ruling on end-of-life care

A recent Ontario Superior Court decision advances the law on end-of-life care, says Lonny Rosen.

In his Aug. 20 decision, Ontario Superior Court Justice Peter Cavanagh dismissed a $2.2-million lawsuit brought against two doctors for placing a do-not-resuscitate (DNR) notice on an elderly patient without first consulting his substitute decision-maker.

“It’s a very interesting case,” says Rosen, adding the case “picks up where the Supreme Court of Canada (SCC) left off” in a landmark 2013 ruling regarding the withdrawal of life-saving treatment.

The SCC in that case confirmed in a 5-2 majority that physicians must obtain consent for the withdrawal of life-sustaining treatment, even if they believe it to be futile or harmful to the patient, he says.

Rosen tells that the Supreme Court’s ruling gave a broad meaning to the term “treatment” in Ontario’s Health Care Consent Act, but he says the decision was of relatively limited practical value due to the special circumstances of that case.

However, he says Cavanagh’s decision fills in some of the holes left by the Supreme Court by exploring the need for physicians to obtain consent from substitute decision-makers before declining to provide — or even offer — life-sustaining treatment that they feel is medically inappropriate.

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