An expert in health law and policy told a Winnipeg conference that doctors do not have legal authority to order cessation of life-saving treatment against a patient’s wishes.

Dr. Jocelyn Downie, Canada Research chairwoman of health law and policy and professor of law and medicine at Dalhousie University, said there is no legal precedent that gives doctors the authority to remove a patient's feeding tube or ventilator against their wishes or to decide whether they meet a "minimum goal" to continue living.

She said judges in previous court cases involving do-not-resuscitate orders haven't ruled whether this power lies with doctors. The question of who decides, Downie said, is still wide open before the courts.

Downie's comments run counter to new guidelines issued by the College of Physicians and Surgeons of Manitoba in February that say the final decision on whether to pull the plug on a patient rests with the doctor.

Those guidelines were also rejected by Judge Perry Schulman, who last February ordered Winnipeg’s Salvation Army Grace Hospital to continue treatment of 84-year-old Samuel Golubchuk.  Hospital doctors want to euthanise Mr Golubchuk, but his family insists that would contradict their Orthodox Jewish beliefs.

Dr Downie hits the nail on the head here:

"You are deciding as physicians what lives are worth living, and that's a moral judgment, it's not a medical judgment," Downie said. "It just goes too far, and that's dangerous."

Exactly.  Doctors lack the moral competence to decide whose life is worth living and whose isn’t.

Dr Bill Pope, the college’s registrar, disagrees with Dr Downie, claiming that Manitoba courts have accorded doctors the right to pull the plug against a patient’s wishes.  No supporting court citation is quoted, and that view flies in the face of Judge Schulman’s ruling that the hospital must maintain Mr Golubchuk’s treatment pending a full court hearing on his case.

Previous related post: Doctors ordered to keep Sam Golubchuk on life support