The Supreme Court of Canada will hear a potential landmark case involving the ethical question of who has the final decision to remove life support.
The case revolves around Hassan Rasouli – the 60-year-old Iranian who, after having surgery to remove a brain tumor, caught a post-operative bacterial infection which subsequently placed him in a vegetative state – and his Sunnybrook Hospital doctors Brian Cuthbertson and Gordon Rubenfeld.
The doctors argue that Mr. Rasouli’s current treatment is hopeless and that consent from Ontario’s Consent and Capacity Board or the patient’s substitute decision-maker is not needed for them to provide or deny treatment.
Mr. Rasouli is being fed through a tube connected to his stomach and is breathing through a mechanical ventilator. His life decisions are being made by his substitute decision-maker and wife Parichehr Salasel.
“The doctors say that they are not legally required to continue treatment that they consider is hopeless including treatment which, if it was withdrawn, would bring about a persons foreseeable death,” said the Rasouli family lawyer Gary Hodder.
Ontario’s Court of Appeal upheld a lower court’s decision last June that required the doctors to receive consent from Ms. Salasel to disconnect life support.
Sunnybrook neurologist Andrew Lim diagnosed Mr. Rasouli as minimally conscious last January after he successfully responded to requests made by his wife to move his fingers and tongue.
The upgraded diagnosis brought the Rasouli family to apply for a motion to quash the Supreme Court case. The motion was rejected on May 17, 2012, causing the case to begin in December 2012. Mr. Hodder said there were no reasons given as to why the Supreme Court rejected the motion.
The Rasouli family still says there are visible signs of recovery and that he is very much alive.
“The new diagnosis gave us more energy to work with my dad and spend more time on his rehabilitation,” said Mr. Rasouli’s daughter Mojgan, who works with her father to help increase his awareness.
Mr. Hodder says the case is very simple and comes down to consent. He also said that the Supreme Court’s decision will define procedure for doctors and people who face similar issues in the future.
“There’s always a point at which anyone’s right to continue medical treatment, to the extent that it exists, is going to be subject to limits,” said Hodder. “This is one of those cases where the Supreme Court of Canada is going to look at where the line gets drawn in this type of case.”
The Supreme Court case will begin on December 10, 2012.