Top court to hear landmark end-of-life case | canada.com

OTTAWA?? The Supreme Court of Canada will hear on Monday the landmark case of a comatose Toronto man whose family and doctors are at odds over whether he should live or die.

Hassan Rasouli, 60, has been ?without consciousness? since 2010, according to court documents. His doctors seek to withdraw life-sustaining treatment and to administer palliative care, while his family has fought to keep the man on the ventilator that breathes for him.

The precedent-setting case will provide some guidance about who gets to decide whether or not a patient continues to receive life-sustaining measures ? whether it?s a medical decision, or a family decision, said Ron Skolrood, a Vancouver lawyer with expertise in constitutional and health law.

?This is something that every one of us is going to face in our lives, whether it?s an aging parent, a spouse, whether it?s ourselves ? we?re all inevitably going to arrive at the point where death may be imminent,? Skolrood said.

?This case, to some extent, will provide some guidance to who makes those fundamental choices when we arrive at that point.?

In 2010, Rasouli suffered complications from surgery to remove a brain tumour that left him with ?severe and diffuse brain damage,? according to court documents. He was diagnosed as being in a persistent vegetative state ? an irreversible loss of consciousness.

There is no evidence that Rasouli?will ever recover any meaningful consciousness, doctors Brian Cuthbertson?and Gordon Rubenfeld?of Toronto?s Sunnybrook Health Sciences Centre say in documents submitted to the Supreme Court.

?At its highest, life-support in this case serves an emotional or credal purpose for Mr. Rasouli?s family. This is not a medical benefit obliging a physician to offer or continue care,? their factum reads.

Rasouli?s wife, Parichehr?Salasel, who is the respondent in the matter as well as a physician in her home country of Iran, wants to keep him alive because she says he does demonstrate some level of awareness and is getting better.

Removing him from life support also goes against Rasouli?s religious beliefs, according to her court documents. Rasouli and his family are devout Shia Muslims, and believe that a person is entitled to stay alive until all signs of life are gone, the documents say.

The case has been further complicated by a change in Rasouli?s diagnosis ? an upgrade in January from a persistent vegetative state to a ?minimally conscious state? (MCS), according to Salasel?s court documents.

Two Ontario lower courts have dismissed appeals by the two doctors, ruling that without Salasel?s consent, the doctors must consult the Consent and Capacity Board.

The doctors applied for leave to appeal at the Supreme Court in August 2011, and the court granted it last December.

At one level, Monday?s case is about interpreting Ontario?s Health Care Consent Act, which sets out the terms to which a person or their family can consent to treatment.

The way that the court interprets the meaning of ?treatment?? ? whether or not it includes the withdrawal of life-sustaining measures ? will have an impact across the country, Skolrood said.

On a broader level, the court will likely also have to weigh in on the policy debate on end-of-life decisions, Skolrood said.

?This test case is so fundamentally important that it will answer the most basic of human questions: who lives, who dies, who decides,? said Eugene Meehan, a partner at Supreme Advocacy LLP in Ottawa, and former executive legal officer at the Supreme Court.

The case has attracted a number of interveners, including the Consent and Capacity Board, the Euthanasia Prevention Coalition, and the Canadian Critical Care Society.

A decision on the case is not expected for some time.

nstechyson@postmedia.com

Twitter.com/natstechyson

Source: http://o.canada.com/2012/12/09/top-court-to-hear-landmark-end-of-life-case/

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