Recently, the Canadian British Columbia Court of Appeal saved a disabled woman from being literally starved to death.
Mrs. Margot Bentley, 83 years old, has advanced Alzheimer’s disease and is living in the Maplewood House community senior care facility. Staff members feed her with a spoon or cup, and she voluntarily opens her mouth to eat and drink.
Twenty-four years ago, she signed an advance directive that, while vague, allowed for the withdrawal of some “nourishments or liquids.” More recently, she made a second statement accepting basic care but, this statement was even less clear, and as the trial court found, neither statement was a legally valid advance directive. Nonetheless, her family has spent years trying to convince Maplewood and the courts to stop feeding her – and intentionally starve her.
In March 2013,a PhD Registered Social Worker “was able to determine what food Mrs. Bentley preferred [and when she did not want any more] – suggesting that she does have some means for communicating.” A hospital palliative care physician shared that opinion, stating, “Mrs. Bentley clearly chooses to eat.”
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The trial court found that Mrs. Bentley may have lost capacity for many things, but not to consent to eat, further, that “consent to health care may be inferred by conduct,” and an act “such as choosing when to accept and when to refuse food,” is nonverbal consent.
As the trial judge affirmed, people can change their minds, whether between written statements or from the written statement to the present day, “which is one of the risks associated with written instructions for the future.” But precedent states that a caregiver must follow a patient’s current wishes over prior directives.
According to the trial court, spoon-feeding is basic “personal care,” not “health care,” and the nursing home has a duty to provide it (or else face neglect and possibly criminal charges relating to suicide or homicide). In other words, yogurt is not a medical treatment – everyone needs food to live. And as the Province of British Columbia argued in its response, just imagine the deluge of paperwork and problems that would ensue if every provision of food or water in a healthcare setting required a signed consent form!
The Bentley case could have become another bump on the slope downwards: refusal of medical treatment, to refusal of tube nutrition and hydration, to suicide via self-starvation (voluntarily stopping eating and drinking, or “VSED”), to VSED in advance, as was almost ascribed to Mrs. Bentley.
We have already seen VSED by someone who was “essentially healthy.” And particularly when VSED in advance is legitimized, it raises questions, as did the Province of British Columbia in its response here, of assisted suicide or euthanasia. Pro-VSED activist doctors have called the process “horrific,” and one patient’s daughter termed it “torture.” But rather than contemplate appropriate medical care, activists such as Robert Risley, head of Americans Against Suffering, suggest a “better way” – assisted suicide and euthanasia: “You wouldn’t put a dog through this. You would give it a lethal injection.”
Rather than succumb to the pressures of the pro-death, anti-disability groups, the trial court gave a strong defense of the inherent worth and dignity of all human beings: “The petitioners’ characterization of Mrs. Bentley as ‘vegetative’ is neither useful nor accurate.” “[I]t is of fundamental importance to respect and care for the person that Mrs. Bentley is now” – rather than merely contrast her current and former abilities. “Spoon feeding … is an act of care promoting the person’s dignity and protecting him or her from neglect, which is in fulfilment of his or her rights.”
The courts found that capacity and consent mean something, and can’t be wished away by an inadequate document signed more than two decades prior.
- Have you ever cared for a loved one in a similar situation? How do you respect and love the person they are now, rather than comparing them to who they were?
- Do you have a loved one in a similar legal situation? Request legal help today.
LifeNews Note: Catherine Glenn Foster is the Litigation Counsel for Alliance Defending Freedom.