Ruling Increases Rights of Patients
“THE right of a person to control his or her own body is a concept that has long been recognized at common law,” stated Mr. Justice Sydney Robins of the Court of Appeal of Ontario, Canada. But what provoked this issue in the first place?
In 1979 Mr. and Mrs. Malette of Quebec, Canada, were involved in a car accident that killed the husband and left the wife severely injured and unconscious. When she was rushed to the hospital, it was found that she was carrying a signed Medical Directive/Release Card, clearly refusing blood transfusions on specific religious grounds. (There are also health hazards associated with blood transfusions.) The doctor who attended her, believing that her situation was critical, ignored those instructions and took it upon himself to administer blood. As a consequence, Mrs. Malette sued the doctor and the hospital for assault and battery and religious discrimination. In the trial court, she was awarded $20,000. The case was appealed to the highest court of Ontario, the Court of Appeal.
One of the arguments repeated in the Court of Appeal decision in favor of Mrs. Malette was:
“The right to refuse treatment is an inherent component of the supremacy of the patient’s right over his own body. . . . However sacred life may be, fair social comment admits that certain aspects of life are properly held to be more important than life itself. Such proud and honourable motivations are long entrenched in society, whether it be for patriotism in war [or] protection of the life of a spouse, son or daughter . . . Refusal of medical treatment on religious grounds is such a value.”
The appeal court opinion continued: “Regardless of the doctor’s opinion, it is the patient who has the final say on whether to undergo the treatment. . . . If a doctor were to proceed in the face of a decision to reject the treatment, he would be civilly liable for his unauthorized conduct . . . A doctor is not free to disregard a patient’s advance instructions [such as the Medical Directive/Release Card carried by Jehovah’s Witnesses] any more than he would be free to disregard instructions given at the time of the emergency.” The court added that “to transfuse a Jehovah’s Witness in the face of her explicit instructions to the contrary would . . . violate her right to control her own body and show disrespect for the religious values by which she has chosen to live her life.”
The appeal judge then made a powerful point against the doctor who had claimed that the card was of no value in this emergency. “I do not agree . . . that the Jehovah’s Witness card can be no more than a meaningless piece of paper. . . . The instructions in the Jehovah’s Witness card imposed a valid restriction on the emergency treatment that could be provided to Mrs. Malette and precluded blood transfusions. . . . Her written statement is plainly intended to express her wishes when she is unable to speak for herself.”
In his conclusion the judge made the logical point that when Witnesses refuse transfusions, “they must accept the consequences of their decision. Neither they nor their dependents can later be heard to say that the card did not reflect their true wishes.”