re a Patient - [2011] NSWSC 432

Supreme Court

New South Wales

Medium Neutral Citation: Application of Justice Health; re a Patient [2011] NSWSC 432
Hearing dates: 30 March 2011
Decision date: 30 March 2011
Jurisdiction: Equity Division
Before: Brereton J
Decision:
Declare that on its proper construction, (NSW) Crimes (Administration of Sentences) Act 1999, s72A, does not require the patient to be given cardiopulmonary resuscitation

Catchwords: UNCONSCIOUS PATIENT - parens patriae jurisdiction - patient inmate at correctional centre - proposal to withhold aggressive therapy which has the effect of prolonging the patient's life - consent of patient to such treatment not required - distinguishable from cases where invasive treatment otherwise constituting an assault is proposed - application of (NSW) Crimes (Administration of Sentences) Act 1999 s72A - whether section precludes withholding of therapy having effect of prolonging patient's life - section deals with treatment necessary for preservation of health, not treatment relating solely to prolongation of life - held: s72A does not require treatment to merely prolong life.
Legislation Cited: (NSW) Crimes (Administration of Sentences) Act 1999, s 2A, s72A
Cases Cited: Health & Community Services (NT), Department v JWB & SMB (Marion's case) (1992) 175 CLR 218
Isaac Messiha (By His Tutor Magdy Messiha) v South East Health [2004] NSWSC 1061
Northbridge v Central Sydney Area Health Service [2000] 50 NSWLR 549
Category: Principal judgment
Parties: Justice Health, NSW Dept of Health (applicant)
Representation: Counsel:
Mr SA Woods (applicant)
Solicitors:
Legal Branch, NSW Dept of Health (applicant)

File Number(s): 2011/103450

Judgment ( ex tempore )

HIS HONOUR: The patient the subject of the present application is presently an inmate in a correctional centre. He has end stage lung cancer, with a prognosis of days or at best weeks. He is not competent to give consent, nor expressly refuse any medical treatment or treatment plan. He has no guardian appointed, and there is no other person who can provide a substituted consent.

The unanimous medical opinion is that further active treatment would be futile. The medical opinion also extends to express the view that it would not be in the inmate's best interests for treatment to continue. As presently minded, I have difficulty in understanding how medical practitioners are able to express conclusions about the inmate's best interests in those terms. Likewise, I have some difficulty in appreciating the argument that such patients should be allowed to "die with dignity", which also appears in some of the evidence; that is a controversial view as to which the views of medical practitioners carry no more weight than others. What I think is important, however, is the unanimous view that further treatment would be futile, in the sense that cardiopulmonary resuscitation would achieve no more than a short prolongation of life without quality.

By Summons filed today Justice Health, which has medical care and responsibility of the patient, seeks the following relief:

1. A declaration that Justice Health may lawfully discontinue all life sustaining treatment and medical support measures designed to keep the Patient alive in his existing…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

Continue reading re a Patient

Details

AGLC: re a Patient [2011] NSWSC 432
Case: [2011] NSWSC 432
Decision Date: 30 March 2011

CaseChat Overview and Summary

In this case, the patient, an inmate at a correctional centre, was unconscious and in a permanent vegetative state. The dispute centred on the proposal to withhold aggressive life-prolonging therapy from the patient. The court was tasked with determining whether the application of the (NSW) Crimes (Administration of Sentences) Act 1999 s72A precluded the withholding of treatment that would prolong the patient's life. The primary legal issue was whether section 72A of the Act, which pertains to the treatment necessary for the preservation of health, required the continuation of treatment solely for the purpose of prolonging the patient's life, or if it allowed for the withholding of such treatment.

The court examined the relevant statutory provisions and found that section 72A of the Crimes (Administration of Sentences) Act 1999 addressed treatment necessary for the preservation of health, rather than treatment that merely served to prolong life. The court held that the section did not mandate the continuation of treatment that solely prolonged the patient's life, thereby allowing for the withholding of aggressive therapy in this instance. The decision highlighted that this case was distinguishable from scenarios where invasive treatment, otherwise constituting an assault, was proposed. The court's reasoning was grounded in the interpretation of the statutory language and its application to the specific circumstances of the patient's condition.

The court concluded that section 72A did not require the continuation of treatment aimed solely at prolonging the patient's life. Consequently, the application to withhold aggressive life-prolonging therapy was permissible. The court's decision underscored the importance of distinguishing between health preservation and life prolongation in the application of the relevant statutory provisions. The final orders reflected the court's determination that the withholding of treatment was lawful under the circumstances presented.

Orders