Her note (the so called “Living Will”) specifically said that if she called an ambulance it was because she did not want to die in pain and alone. You can read the whole text here.
I’m with you here. If she showed up in my ER I’d assume the ‘Living Will’ was evidence of premeditation of her suicide attempt and thus invalid. She would have been treated without hesitation.
Also, we’re generally using fomepazole and/or hemodialysis these days as opposed to ethanol infusions for ethylene glycol ingestions.
Thanks, MarcusF.
I’m tight for time, but I’ll get back on this over the weekend if not earlier.
BTW, this BBC report sheds a bit of light on the matter: BBC NEWS | UK | England | Norfolk | Doctors 'forced' to allow suicide . It sounds like the lady was conscious when she made her directions, the doctors took care to check out her mental capacity at that time, and the hosptial did not rely on her suicide note.
If the suicide note was not taken into consideration, and if she gave the directions when she was conscious and appeared to be of appropriate capacity after proper investigation, the decision by the coroner makes more legal sense, but it still would be a decision based on a finding of fact rather than a step forward in the law.
Anyone happen to have a link to the coroner’s reasons?
On a related note, I recall (but don’t quote me, for I am not certain – I’ll have to look it up) that there is a provision in England’s Mental Capacity Act that permits treatment to be given on an interim basis while the doctor takes the matter to court for a decision on whether or not treatment should be given. At a gut level, that’s the approach I would have recommended – if in doubt as to capacity, keep the person kicking, and let a judge decide whether or not to pull the plug.
PG Dip MHL = post-graduate diploma in mental health law. I would love to see that coroner’s written reasons!
Well done, Muffin! Nice explanation, and I must say, your clause about “heroic measures” etc. is comprehensive–perhaps more than the precedent I’ve been using. If it’s OK with you, I may see if I can use it here from time to time, as appropriate.
Just as an aside, Muffin, are you familiar with the Stella Lacroix incident, from about 20 years ago in Ontario? Another suicide attempt (which was ultimately successful), but made before living wills were common; and the medical people did get involved. Ms. Lacroix’s capacity may have been in issue; I don’t recall, since it’s been years since I reviewed it. There was no court case, but the fallout from the incident spread to physicians, hospitals, and all the way to Queen’s Park; and the coroner’s jury that was subsequently convened made a number of interesting findings of fact as well as recommendations. Anyway, if you ever get curious, you might want to look up what that jury had to say.
This is the only suitable course of action in my mind. I presume that anyone who attempts or considers suicide has forfeited their capacity to make their health care decisions.
Ok, thanks. That makes sense.