Yes, that’s enough. If she said, “I understand that without this surgery I will die, and I don’t want this surgery,” it would be a much clearer case not to treat her. Because she brought in the delusion that God cured her already (when the doctors can still see the cancer), *she *created a sticky mess. A person with delusions is not mentally competent.
I suspect she figured this out (or someone told her this) and that’s why the second mental health evaluation found her maybe competent. She changed her tune, saying that she knows she’s still got cancer, and most people with this cancer will die without medical treatment, but she’s still hanging her case on the hope that God WILL cure her. This isn’t such a clear cut delusion, so now it’s more complicated than ever. Now we’re deep into the “is religion delusional”? debate, one on which mental health professionals have become tapdancers with more skill than Fred Astaire.
Really, people, if you don’t want treatment, leave God out of it. Just repeat back all the bad things the doctor told you might happen, tell him you accept those risks, and then you can refuse treatment without all this nonsense. (Unless there are children or fetuses involved; then it gets ugly.)
Yes, it is (was, at the time of the first hearing). Unless, of course, she’s been cured, then it would just be a fact. But she hasn’t. Therefore, the persistent idea that she’s been cured - whatever the mechanism - is a delusion. A delusion is a persistent idea not shared by one’s culture or religion. Now that she’s changed her story, of course, it’s hard to call it a delusion, because many religious people share the belief that God can cure them, and a delusion, by definition, is a belief not shared by one’s culture or religion.
If she claimed she cured herself with chamomile tea, but the cancer was still there, it would be just as delusional. Religion needn’t enter into it.
We’re taught that Advance Directives and DNR orders trump Medical Power of Attorney. That is, the PoA can allow or disallow anything as long as it does not conflict with the AD or DNR. Is this not correct? (Or is this one of those School vs. Real World issues?)