(2) In re T (Adult:
Refusal of Treatment) [1993] Fam 95, 112, 115 (per Lord Donaldson MR) (Eng CA).
The law has recognised that, in such a case, a health professional should not be required to comply with the advance
refusal of treatment. For the health professional to be excused, however, the change in circumstances must be 'sufficiently relevant and significant to justify disregarding' the advance directive.
On the other hand, if the parental
refusal of treatment were based on religious views, but the blood transfusion were controversial given the medical condition of t he child, the parents' refusal should be respected, even though it was not based on the same reasons for which the court might consider non-treatment as compatible with the best interests of the child.
Refusal of treatment is controversial in terms of the physician's principle of beneficence.
Let me say something about the question of consent,
refusal of treatment, and advance directives.
They engage the standard concerns of the conflict of principles, the determination of a patient's competence and consent to or
refusal of treatment, confidentiality, paternalism and its justification, and euthanasia.
Nominal and operational definitions on choice of degree of treatment Operational definition Nominal definition Degree of treatment Refusal of referral
Refusal of treatment Purely palliative treatment 1 with penicillin in the nursing home Acceptance of treatment Curative plus palliative 2 with penicillin treatment in the nursing home Acceptance of referral Refusal of respirator Curative plus palliative 3 treatment in hospital (minus intensive care) Acceptance of respirator Curative plus palliative 4 treatment in hospital (plus intensive care)
Although the Act does not enlarge or constrict the scope of patients' rights in psychiatric settings, it raises three kinds of questions at the intersection of the law of
refusal of treatment and the law of advance directives.
According to contents of the FIR, precious human lives were lost owing to 'substandard material and lack of precautions and safety measures and
refusal of treatment and negligence' of the three suspects.
The patient understands the consequences of the decision (especially
refusal of treatment).
Assisted suicide compared with
refusal of treatment: A valid distinction?