Health: Surgeons' right to let patients die
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Your support makes all the difference.Surgeons were yesterday told they have a moral right not to prevent the death of a brain-damaged patient doomed to living a "demonstrably awful life".
The final decision should be taken by the consultant in charge, guidelines from leading surgeons said.
The "duty of care" ethical and legal guidelines from the Senate of Surgery of Great Britain and Ireland spells out situations where it is permissible for life-saving or preserving treatment to be withdrawn.
It says such treatment does not have to be given to adults or children who cannot think for themselves where such action is believed by the clinical team - in consultation with relatives - to be in the patient's best interests.
Three situations were listed where the non-treatment option, possibly leading to the patient's death, could be considered.
One was where doctors agreed any further treatment was futile and would not save the patient's life. Another was where the patient was "irreversibly and imminently close to death" and treatment would not improve his or her condition.
The third, and most controversial, situation was where a patient had "devastating and permanent neurological injury which is so incompatible with any form of conscious self-directed activity as to count, in the circumstances of the patient, as a demonstrably awful life".
In this case there was "sufficient potential moral and legal debate" to require the final decision to withhold life-saving treatment only to be made by the chief consultant, who may wish to take legal advice.
Although active euthanasia - a clinical choice directed at killing the patient - is illegal in Britain and Ireland, the guidelines say that surgeons should respect the "living will" wishes of patients who ask that specific treatments should not be given for particular conditions, such as irreversible brain damage.
The guidance also makes it clear that surgeons should inform competent adult patients aged 16 and over of the nature of their condition along with details, including side effects and risks, of any proposed surgery. An attempt should be made to ensure the patient understands the site and size of a surgical incision and the pain and discomfort which may follow the operation.
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