This is an interesting report by Alex Schadenberg. It goes over old ground in many respects but does go to show that Advance Directives, even though they can and do provide the opportunity for clarity of intention and choice, can still present difficulties.
An article in the Vancouver Sun reported on the family of Margaret Bentley (82) that have launched a lawsuit against Fraser Health and the BC government concerning the fact that Bentley is being spoon fed at the Maplewood Care Facility in Abbotsford BC against the wishes of the family and allegedly against the previously stated wishes of Bentley.
This court case will determine: whether or not feeding someone with a spoon is providing a "basic necessary of life" or whether it constitutes medical treatment that must be withheld upon request or it becomes an assault and battery?
Alex Schadenberg, the executive director of the Euthanasia Prevention Coalition recognizes that all Canadians have the right to have treatment withdrawn or withheld, but food and fluids provided by normal means, such as a spoon, constitutes basic care and not medical treatment.
If Bentley, who willingly opens her mouth and swallows is denied food and fluids, that this is a denial of basic care. The article states that Bentley prefers desert, meaning that she enjoys food and she can distinguish between food types.
Schadenberg also stated that:
Withholding food and fluid from Bentley will cause her to intentionally die of dehydration, a death which is not compassionate or comfortable.
The Euthanasia Prevention Coalition recognizes that:
Elder abuse is a growing problem in Canada, and giving health care providers and families the right to deny people basic care will only lead to new paths to abuse.
Spokespeople for the government and Fraser Health said late Tuesday they wouldn’t comment on the case since it’s now before the court. But previously, Fraser Health official Keith McBain said health care workers are “obligated to provide the necessities of life for patients … that includes food and fluids.”
Fraser Health contends that patients can refuse feeding tubes but spoon feeding is different and does not fall into the category of heroic or extraordinary life-saving measures. ...
The article quotes an ethics consultation that was done for Fraser Health that determined:
“The risk of feeding her is minimal whereas the risk of not doing so means that death will be imminent. This death would be viewed as premature and so would constitute harm to Mrs. Bentley,”
The article stated that an advanced directive that was signed by Bentley in 1991 stated that:
"she didn’t want to be fed “nourishment or liquids” if she ever developed an incurable medical condition involving mental or physical disability. She said she wanted to be allowed to die."
The article stated that:
In the suit filed on behalf of Bentley, the plaintiffs are asking the court for a declaration that the feeding is akin to battery and that the facility is violating her Canadian Charter of Rights and Freedoms. The suit relies upon 18 other rules, regulations and statutes in a bid to prove that Bentley’s rights are being violated.
The Euthanasia Prevention Coalition is discussing its response to the Bentley spoon feeding case. Clearly, feeding Bentley with a spoon is not akin to Battery.
All people who require assisted feeding would be negatively impacted if the BC court declares that the provision of food and fluid, by spoon, constitutes battery.