The right to refuse medical treatment

From the archives: The original post was posted on 22nd March, 2002

In view of the factually mistaken and morally wrong ideas about forcing medical treatment on people that are often expressed, I thought this legal case might be of interest:

Woman welcomes ‘right to die’ ruling

A woman paralysed from the neck down has been told by the High Court that she has the right to have her life support machine turned off.

It is noteworthy that:

  • The ruling is nothing new. It conforms to the centuries-old (in the English legal system) principle that every competent adult has the absolute right to refuse medical treatment.
  • The woman is not in chronic physical pain. (If she were, she could have asked doctors to give her enough painkiller to kill the pain, even if this killed her, and this would be legal.)
  • She is not dying.
  • She has a one per cent chance of eventually making a recovery.
  • She has been awarded damages for the assault (“trespass”) that the doctors committed by giving her the unwanted medical treatment that was necessary to keep her alive. It was a token amount (100 Pounds) but the hospital has also been ordered to pay her legal costs of 55,000 Pounds.
  • The doctors had argued that their primary duty is to protect life. The court rejected this argument.
  • Dr Richard Nicholson of the Bulletin for Medical Ethics also rejected it, saying: “The first requirement of the Hippocratic Oath is ‘do no harm’. If you are preserving life at all costs but in order to do so the patient reckons you are harming them… then you are in breach of that first ‘do no harm’ requirement.”
  • In a last-ditch argument, the doctors asked the court to give them more time to improve her quality of life before it granted her wish, so that she might change her mind. The court refused.
  • A politician who has been following the case criticised doctors for not respecting their patients’ wishes and said: “Some doctors still don’t have the message that patients have a right to decide their own destination with regard to treatment – even if that decision is felt to be irrational. If a patient has capacity that wish has to be respected.” Naturally, no participant in the case has noticed that not a single one of those wonderful arguments about the rights of “competent adults” to have the last word in regard to what is done to them depends in any way on the person’s age. The logic of the argument would be unchanged if the phrase were replaced throughout by the phrase “competent people”. Replacing “people” by “adults” in the discussion makes exactly as much sense, logically and morally, as replacing “people” by “white people”.

See also:

David Deutsch, 2002, ‘The right to refuse medical treatment’,