The right to refuse treatment

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The concept of a "living will" will probably seem strange to many people. A will divides up your estate when you die - not something most people would want to come into effect while they are still alive. But it makes more sense when you consider the case of someone afflicted with a degenerative mental disease, who will one day lose the ability to manage their affairs. A living will allows them to appoint someone - perhaps a partner or relative - to make financial decisions on their behalf.

The concept of a "living will" will probably seem strange to many people. A will divides up your estate when you die - not something most people would want to come into effect while they are still alive. But it makes more sense when you consider the case of someone afflicted with a degenerative mental disease, who will one day lose the ability to manage their affairs. A living will allows them to appoint someone - perhaps a partner or relative - to make financial decisions on their behalf.

Yesterday, in a welcome move, the Government published a bill to extend the scope of living wills, allowing appointees to refuse medical treatment on behalf of an incapacitated person. The seriously ill will now have the power to state that they should be allowed to die under certain circumstances.

Some will be appalled by the idea of people signing their lives away. Others will argue this is a way of legalising euthanasia by the back door. But these objections ignore the fact that any patient has a right to refuse treatment. Any individual who knows he or she will one day lose the capacity to communicate effectively should be able to set down their wishes about what treatment they receive in advance, rather than have the choice made for them by doctors later. And if they choose not to receive treatment, something that may result in their death, we should respect that choice.

It also makes sense from the point of view of the medical profession. As things stand, doctors must agonise over whether to withhold treatment would be to break their Hippocratic oath to "do no harm". How much more bearable would their duty be if they had clear instructions from the patient? And for relatives, knowing what their loved one wants would substantially ease their burden too.

So this is not euthanasia by the back door but a method of ensuring a patient's wishes are carried out. It is in the interests of all concerned. But that is not to say our laws prohibiting euthanasia do not need to be reformed too. This bill is a step forward in allowing people to die with dignity, but the Government must now turn its attention to legalising euthanasia for people in extreme suffering and who are able to communicate a clear desire to end their life.

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