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Medicine and the Law

Withdrawal of artificial feeding from a dying patient

Loane Skene, Paul Nisselle

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Abstract

Medical treatment, palliative care and futile treatment are considered in this discussion of the lawfulness of withdrawing artificial feeding from a patient who had been in a persistent vegetative state for three years and showed no signs of improvement.

Article Extract

The Victorian Supreme Court recently ruled that, under Victorian legislation, it is lawful to withdraw percutaneous endoscopic gastrostomy (PEG) feeding from a patient in a persistent vegetative state on the request of the patient while competent or the patient’s State-appointed guardian (Gardner; re BWV). The impact of this decision is not limited to Victoria. Although the judgment was based primarily on the Victorian Medical Treatment Act 1988, which gives patients and their agent or guardian a statutory right to refuse treatment, patients also have a common law right to refuse medical treatment – a right that exists throughout Australia. The judgment therefore suggests that doctors can lawfully withhold or withdraw artificial feeding from patients who have given an advance directive refusing all treatment. Artificial feeding is not in a special category of treatment that must continue to be given even if other treatment can lawfully be withdrawn or withheld.

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