In a 44 page judgement, Mr. Justice Greyell of the Supreme Court of British Columbia has ruled that family members cannot order caregivers at a nursing home to starve an 83 year old resident to death. Margot Bentley, age 83, is in the final stages of Alzheimer’s disease. Based on written instructions she left before being diagnosed with the disease, family members went to court to stop caregivers from spoonfeeding her when she opened her mouth to accept food. The judge noted that she is not dying, and that to comply with their wishes wold mean that Mrs. Bentley would die from starvation and dehydration and not an underlying disease.
Having considered the evidence, he rejected the claim that Mrs. Bentley is in a “vegetative state” as “neither useful nor accurate,” concluding, instead, that it was possible that she had sufficient mental function to decide whether or not to eat and drink and to communicate that decision in non-verbal ways. He held that spoon-feeding was not “health care” within the meaning of the law, but a form of personal care. While he agreed that, under the common law, a competent adult can refuse food and fluids and thus commit suicide, he ruled that there was no legal precedent for the finding that such a decision could be made on behalf of an incompetent person by a proxy decision maker. On the other hand he recognized statutory and public policy considerations that would tell against such a finding.
The case is of interest because it demonstrates how the kind of directives the family pursued in this case can generate conflicts of conscience among caregivers and health care workers.