Right of refusal

18 November 2009

Associate Professor Cameron Stewart discusses the importance of medical patients having an Advanced Care Directive (ACD) in the latest edition of Australian Doctor.

He says says it is clear under common law that a patient can refuse any type of medical treatment and for any type of reason, be it rational or irrational.
He adds that while recent judgements, such as those in New South Wales and Western Australia, deal with refusing treatment, they don't compel doctors to provide treatments demanded by patients.
"There is no duty of care that forces a doctor to provide a treatment that a patient has demanded if the doctor disagrees with that treatment.

"This includes, of course, requests for euthanasia."

Professor Stewart says if it is an emergency and an ACD hasn't been found, the principle of necessity applies.

"A doctor is permitted to provide treatment to the patient in order to save a life or prevent harm," he says.
"But at the same time it is also a doctor's duty to look for an advance care directive.

"For example, if a patient is moved from a nursing home to a hospital, the hospital staff should ask the nursing home if one has been completed."

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Contact: Greg Sherington

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