Alzheimer’s Patient Lost Right-to-Die Despite Expressed Wishes

Today, BC Court of Appeal dismissed the appeal brought by the family of Margaret Anne Bentley, a patient at the final stage of Alzheimer’s disease. My colleague Amy Mortimore posted a blog when the family of Mrs. Bentley commended the lawsuit in August 2013, and Areet Kaila posted a blog when the BC Supreme Court released its decision in February 2014.

In 1991, Mrs. Bentley signed a “statement of wishes” in which she asked that she be allowed to die should she suffer from an extreme disability with no expectation of recovery and that she not be provided with nourishment or liquids. In another undated “statement of wishes” purportedly to have been signed by Mrs. Bentley as well, she asked that she be allowed to die and not be kept alive by artificial means such as life support systems, tube feeding, antibiotics , resuscitation or blood transfusions. She also indicated in this undated document that she would accept basic care and request aggressive palliative care, drugs, or any other measures to keep her from pain or distress.

In 1999, Mrs. Bentley was diagnosed with Alzheimer’s disease. By 2013, Mrs. Bentley lost her ability to make physical movement, and had not spoken since 2010. She did not recognize her family members or any other person.

In 2013, Mrs. Bentley’s family commenced the lawsuit seeking, amongst other things, a declaration that Mrs. Bentley not be given nourishment or liquids. The family asserted that Mrs. Bentley expressed strong wishes while she was mentally capable that she did not want to be given nourishment or liquids in her current condition.

The Respondents, the care home in which Mrs. Bentley stayed and Fraser Health Authority, maintained the position that despite the advanced stage of her illness, Mrs. Bentley chose to open her mouth and eat, and this choice must be respected. The Respondents argued that to refuse to offer food and liquids would constitute neglect under the Adult Guardianship Act.

The lawsuit was heard in December 2013, and by Reasons for Judgment released in February 2014, the BC Supreme Court held that there is a distinction between health care and personal care. The Health Care (Consent) and Care Facility (Admission) Act makes it clear that health care must not be provided without obtaining consent, but offering food on a spoon is personal care to which Mrs. Bentley is capable of consenting through her behavior, by opening her mouth for food and liquids. The Supreme Court held that British Columbia legislature did not intend to allow reference to previously expressed wishes to be relied on to refuse basic personal care that is necessary to preserve life.

The family of Mrs. Bentley appealed the decision of the BC Supreme Court. By Judgment released today, the Court of Appeal upheld the lower court’s decision.

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