As most of you know, I have a fairly strong view on how we go about resuscitating all and sundry, even when it does not appear to be the right thing to do. One thing I had not really considered in the past was the actual case law side of things in the jurisdiction in which I work. This is not to say that I had never considered the legal ramifications of the decisions I made, but I have always tried to do what I believe to be the best thing for the patient, rather than what will keep me out of court.
Fortunately in Australia, we have someone who does consider the actual legalities of providing care as paramedics – Dr Michael Eburn. Dr Eburn runs a blog called Australian Emergency Law, and if you have not seen it before and work in Australia, you probably need to head there now. Michael responded to a tweet of mine following some comments coming out of the NZRC conference last month with the following post on the legal view of starting, or withholding resuscitation when it is not in the best interests of the patient.
In a nutshell, it seems that in Australasia at least, resuscitating a patient in whom resuscitation is not in their best interests (for example the terminally ill or the terminally old) is probably a very bad idea: “the law is clear, if treatment is not in the persons best interests it is not only appropriate to withhold that treatment, in Lord Browne-Wilkinson’s view it may be both a crime and tort to administer treatment that the practitioner has reasonable grounds to believe is not in the patient’s best interest”
Read the entire post below, and as always I welcome feedback, comment or criticism.
I’m responding to an issue on ‘twitter’ (but a word of caution, I really don’t follow twitter and rarely look at my account, so this is not an efficient way to get in touch with me; but it worked this time).
The ‘tweet’ says
“NZ case law confirms no requirement to resus when medically not in their best interest. #nzrc2014” same in Oz? Ping @EburnM
The link is to, I think, the New Zealand Resuscitation Council.
The case law is clear and that may be because the key cases come from the UK. I’m not sure what NZ case law the speaker was referring to; but in Australia the law that justifies treating a person who cannot give consent is the principle of necessity. In In Re F  2 AC 1 Lord Justice Goff set out the test for necessity. He said (p 25, emphasis added):
… not only…
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