Court rules MUHC can change treatment plan for dying patient

A Quebec Superior Court judge has granted the McGill University Health Centre the right to proceed with end-of-life care in the case of a 74-year-old woman, despite opposition from herfamily. The woman has been in intensive care at the Royal Victoria Hospital since the end of July and has no hope for recovery.

The MUHC had asked the court to rule if it should stop providing treatment and respiratory support to the woman, and replace the current treatment plan with palliative and comfort measures.

In her ruling, Superior Court Justice Karen M. Rogers detailed the woman's condition. The woman has Stage 4 Hodgkin's lymphoma thatcannot be treated. She has also suffered from acute kidney and liver dysfunction, and has had multiple organ failures in addition to several other ailments. She is also currently on a ventilator and is unconscious and unable to communicate.

In his submission to the court, the woman's physician, Dr. Gordan Samoukovic, said she is essentially deadand is being kept alive by artificial means.

"The current treatment is keeping her alive but preventing her from dying peacefully and in dignity,"Samoukovic said.

Woman is 'actively dying in agony'

Another doctor confirmed Samoukovic's opinion, stating,"Therapeutic futility has been reached and this woman is actively dying in agony."

The hospital and the woman's family agree she is incapable of giving, or refusing, consent to change her treatment. But they differ on whether to change her treatment plan to palliative care.

The ruling notes that MUHC and the woman's family recognize she is unable to give or refuse her consent to a change to palliative care. But the woman's husband and one of her sons categorically refuse any change to bring about end-of-life care. Another son testified he is in favour of the change in treatment proposed by the MUHC and he believes his mother would also consent if she could.

In her ruling, Justice Rogers found the current treatment plan is not beneficial to the woman, and that she is suffering in pain.

"She is unconscious, is in the final stage of her life, and has no hope for any quality of life," writes Rogers. "The family's refusal to modify the treatment plan is unreasonable under the circumstances and not in the [woman's] best interest."

Rogers authorized the MUHC and the woman's treating physician to stop the current treatment and administer palliative and comfort care measures.