End of Life Decisions and the HCCA
The Ontario Court of Appeal has upheld a decision of the Superior Court of Justice that doctors must get approval from the Consent and Capacity Board in circumstances where their decision to withdraw life-support treatment is contrary to the wishes of a patient's family.
In her decision as the lower court Judge, Madam Justice Himel concluded as follows:
"Treatment” under the HCCA includes the withdrawal of life support. Therefore, doctors require consent when withdrawing life support in Ontario. End of life cases present very difficult considerations for all parties involved. It is clear from the evidence that the hospital, doctors and substitute decision-maker in this case all have as their priority the best interests of the applicant. We are fortunate in Ontario that our legislature has provided a statutory scheme to assist doctors and substitute decision-makers in determining when an incapable person should be removed from life support, complete with recourse to an independent, expert tribunal in the event that a dispute arises in applying the best interests test. This statutory scheme will allow the applicant’s doctors to challenge the substitute decision-maker’s decision refusing consent to the proposed plan at the CCB. While no end of life decision can be easy, the process established by the HCCA provides consistency and ensures a full consideration of an incapable person’s best interests in cases such as this."
The Ontario Court of Appeal agreed that Mr. Rasouli's physicians required the approval of Ontario's Consent and Capacity Board before they could take the patient off a ventilator.
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