How to express what you want: end-of-life care

Last week, the B.C. Supreme Court released reasons for judgement in the case Bentley v. Maplewood Seniors Care Society. Most newspapers in the province have published reports on the case. 

The family were reportedly very disappointed with the Court’s decision, because they felt that the patient (their mother) did not want to be kept alive in her existing state of advanced dementia. The family filed a Petition, asking for an Order that their mother not be given further nourishment or liquids.

In denying the Petition, the Court held, in part, that the patient took nourishment when it was offered, and thus was capable of making the decision to accept oral nutrition and hydration.

Another part of the decision examined the documents that the patient had signed approximately 22 years ago. At that time, Representation Agreements were not commonly used, nor did the present-day legislation exist. Still, the Court held that the documents (called “Statements of Wishes”) did not constitute a valid Representation Agreement or Advance Directive. 

My view is that, given the existing legislation is still fairly new, interested people should inform themselves of the options they have. Given that there is a lot to get familiar with, in my opinion, it is best to consult with a Lawyer who practices in that area of law. 

In this case, the Court also held that even if the patient had been found incapable of making the decision to accept nutrition, the existing legislation does not allow a Representative or Substitute decision-maker to refuse basic life-preserving care (it would potentially be neglect under the present Adult Guardianship Act). 

This is perhaps the most controversial of the Court’s holdings in the case. It suggests to me that a proper Representation Agreement or Advance Directive may apply when a patient is in a medically “vegetative” state, unlikely to recover (and so life-preserving machinery could be disconnected), but it will not allow a person to end the life of an incapacitated person. 

It’s hard to distinguish. And it’s a signal, to every family with an elderly member, to get good advice.

This ad ran in the Richmond Review on February 14, 2014.