Right to Life Australia (RTLA) supporter Ted Watt doesn’t like the ‘Advanced Health Directives’ (AHDs) which may become available in WA soon. By making one of these directives, competent patients may refuse consent to specified treatments or to any treatment for specified illnesses, to take effect later if the patient should become incompetent. The bill before state parliament provides for ‘Enduring Guardians’ and ‘Persons Responsible’ to be appointed with power to make all health care decisions on behalf of an incompetent patient. (Dr Ted Watt, ‘WA to Debate Medical Treatment Bill’, RTLA News, Jul.-Aug. 2006, 4)

Being the good Right-to-Lifer that he is, Dr Watt (not a medical doctor) takes a dim view of all this. ‘Enduring Guardians’, for example, may not act in the patient’s best interests but rather out of ‘ignorance, malice, impatience, bossiness [or] misplaced compassion’. Watt asks:

Could an AHD come into force so as to override the personal decision of a patient who is still competent to make decisions for himself? Easily.

Now here’s Ted’s example:

Think of patients with severe disabilities, or with degenerative conditions such that the doctor thinks they would be ‘better off dead’, so that if they ask to go on being treated, that proves they are not capable of making ‘reasonable decisions’!

Does Ted give an historical instance of something like this ever having happened? Of course not. He simply proceeds to construct a list of other imaginary circumstances that might raise doubts about the bill in the minds of the unwary:

While requiring that the ‘Person Responsible’ must have some connection with the patient, that connection may be tenuous. There is nothing in the Bill to prevent power over the patient’s life or death being conferred on the patient’s bossy neighbour.

Watt concludes by raising obfuscation to the status of an art form:

Autonomy can only be exercised in person - you cannot exercise my autonomy. So if I am genuinely incompetent to make my own medical decisions, then my autonomy is lost. The decisions that you make in place of me (even if I gave consent to your appointment as my Enduring Guardian) are your decisions. They are not my decisions because I am no longer competent to make decisions.

Ted, as I’m sure you’re well aware, the whole point of this legislation is to help overcome problems associated with the anticipated future loss of a patient’s autonomy. That is to say, the proposed law deals with a situation in which the individual’s autonomy has already been lost. ‘Living wills’, ‘advanced health directives’ and similar instruments represent an effort to come to terms with this situation. You may well be unconcerned about the circumstances of your dying days and moments. Many other people are very concerned and should be given the opportunity to make considered decisions about them while they are still able to do so.

Filed in: People, Voluntary Euthanasia