Citation

Philpot SJ. J. Law Med. 2019; 26(3): 557-570.

Affiliation

Student, Melbourne Law Masters program; Intensive Care Specialist, Cabrini Hospital, Malvern, Victoria; Senior Adjunct Lecturer, Monash University, Victoria; National Lead Trainer, Organ and Tissue Authority, Canberra, Australian Capital Territory.

Copyright

(Copyright © 2019, Thompson - LBC Information Services)

DOI

unavailable

PMID

30958649

Abstract

An advance care directive (ACD) is a written expression of a person's preferences in relation to health care, which can appoint a trusted substitute decision-maker, describe personal values, and make explicit decisions consenting to, or refusing, certain treatments. When a person with a directive refusing life-sustaining treatments attempts suicide, opinions are divided as to the degree to which health care staff are bound by such a directive. In this section, I will provide an example of a patient who presents to hospital after attempting suicide who has a valid ACD refusing life-sustaining treatment. I will then describe the legislation relevant to ACDs in Victoria, Australia and ethical arguments relating to the application of an ACD in this context. I will present a decision-making algorithm for health care staff faced with the difficult decisions arising from such a presentation.

Language: en

Keywords

advance care directive; ethics; resuscitation; suicide; withholding treatment