DOCTORS and paramedics must withhold life-saving medical care if a patient has previously made a ”living will” that clearly states they do not want a specific treatment, such as kidney dialysis or a blood transfusion.

A landmark NSW Supreme Court decision has upheld the right to refuse medical treatment, even if the decision was made only in anticipation, and well before treatment was needed.

Doctors’ groups have welcomed the decision, saying it allows them to respect a patient’s wishes without fear of prosecution or litigation by relatives.

The case concerned Mr A, a Jehovah’s Witness, who had been admitted to an emergency department in a critical state on July 1. He subsequently developed renal failure and went into a coma, kept alive only by mechanical ventilation and dialysis.

On July 14 the hospital discovered that almost a year earlier Mr A had prepared an advanced care directive that specifically refused dialysis.

Aware that stopping the treatment would bring on death, the Hunter New England Area Health Service sought an urgent hearing to determine if the directive was valid.

Justice McDougall said that while there was no legislation covering the issue, the common law right to refuse treatment stood – regardless of its basis on religious, social or moral grounds, and whether or not it was a sensible, rational decision based on the relative risks and benefits.

But a partner at TressCox Lawyers, Don Munro, said hospitals should be reluctant to rely on the Mr A judgement. It would be safer to get an urgent declaration from a judge on each case.

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