The Editor, Re: "Having the right to die," Editorial, Aug. 14.
The disregarding of an advance directive in the feeding of a person in a vegetative state needs to have some clarity for those of use who have thought about and planned for such an evanuality.
One ethical framework includes three basic concepts - autonomy: respect for self-determination; beneficence: moral requirement to promote good; non-maleficence: do no harm.
The advance directive in the case of this person being maintained with nourishment was specific in stating that this not be done as she didn't wish to live out her life being "maintained" with very low quality of life.
It is clear that her autonomy has not been respected as she gave an advance directive while legally competent to do so.
Then do beneficence, the requirement to promote good and non-malfeasance outweigh her autonomy and her specific denial of consent? The claim of good, either individually or publicly is not met as feeding her is not a good in either context.
Non-maleficence, the prevention of deliberate harming of another is less clear but carrying out her wishes by doing nothing as opposed to going against those wishes by a deliberate act seems to be carrying out an intervention without consent of either her advance directive or the wishes of those who can give consent on her behalf, in this case her children.
Hence, the acts being done to her meet her definition of harm or maleficence.
No active harm is being done, even though the outcome will be death, when her wishes are met.
Fraser Health should be charged with assault as they are administering treatment, in the form of feeding, specifically against consent.
This would require the courts to rule on consent given or withheld in an advance directive and by competent people acting on behalf of this most unfortunate lady.
Not carrying out a treatment because consent is refused has been debated for underage persons deemed not old enough for consent. We now need a ruling that allows our wishes to be followed while in a position to give or withhold consent.
Those of us who have prepared advance directives to give directions on our wishes need to have this clarified so the horror of living with no measurable quality of life does not become our fate as well.
Death is not a failure of the healthcare system and should be seen as an event to be planned for and made as peaceful as possible not postponed, no matter the circumstances.
Richard Mathias
Richmond
