Decision-Making: At the End of Life and the Provision of Pretreatment Advice

Abstract

Despite a dearth of affirmative judicial or legislative guidance, it is generally accepted that a capacitated individual may legally and ethically hasten his or her death by voluntarily stopping eating and drinking (VSED) (Pope and Anderson2011). In contrast, it is far more controversial whether an individual can VSED when s/he lacks capacity to do so contemporaneously (Menzel and Chandler-Cramer 2014). It remains unsettled whether an individual may use an advance directive or surrogate decisionmaker to restrain caregivers from offering food and fluids when s/he later reaches a pre-defined state of advanced dementia. Two new court decisions from the Canadian province of British Columbia are among the few in the world to address the legitimacy of advance VSED (Bentley v. Maplewood Seniors Care Society, 2014 BCSC 165; Bentley v. Maplewood Seniors Care Society, 2015 BCCA 91).

Keywords: decision-making, end of life, provision of pretreatment advice

JEL Classification: K00, K30, K32