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Advance Refusals of Life-Sustaining Medical Treatment: The Relativity of an Absolute Right
Authors:Sabine Michalowski
Affiliation:Senior Lecturer in Law, University of Essex
Abstract:English law gives the competent patient a right to refuse life-saving treatment, either contemporaneously or in an advance directive. This means that the patient's autonomous choice that in an anticipated situation his/her interests are better served by rejecting life-saving treatment needs to be respected. However, this right is undermined in practice by the courts' approach of applying a presumption in favour of preserving the patient's life whenever the validity and applicability of an advance directive is questioned. The article argues that the patient's right to refuse life-saving treatment only receives the respect it deserves if the decision whether or not a valid and applicable advance directive exists in a given case is instead be approached in an unbiased, disinterested way, and it analyses how this can be achieved in different scenarios.
Keywords:Advance directive    Advance refusal of life-saving treatment    Interpretation of advance directives    Presumption in favour of life    Disinterested approach    Change of circumstances
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