Julian Green 40159162Case study assignment: Refusal to Consent to a DNR for a Minor Child: Manitoba Court of Appeal CaseChild and Family Services of Central Manitoba v. R.L.Deciding to euthanize someone is no easy task. It's quite difficult to be at a crossroads where thebest solution is to end a life. Euthanasia requires the family and patient, as well as the primary physicianto all come to the same conclusion. This difficult decision becomes particularly difficult when it is notpossible to place the decision in the patient’s hands. In this case, the patient is a three-year-old childwho was so severely physically abused by his parents that the child to fell into a persistent vegetativestate, also known as PSV. It was medically concluded that no amount of medical care would result in thechild getting out of PSV. The healthcare professionals then pondered upon the following dilemma :“Should a “Do Not Resuscitate” form be signed?”. In order to escape manslaughter charges, the parentsof course refused to sign, contrary to the patient’s medical doctor’s recommendation. Disagreementover fact and disagreement over moral importance of outcome are different, contrary to commonthought. The reasons why parents are usually the ones to make these types of decisions for theirchildren is because they, in theory, should know more than anyone else in the world what the bestcourse of action is for their child, despite certain instances where parents make crazed decisions. Forexample, when Jehovah's witnesses refuse life-saving blood transfusions for their kin, they truly dobelieve that this is what is best for the child in the long-term, be it in this life or the next. However, in thiscase, it is quite clear that the parents' decision is what is best for them, and not what is best for theirboy. When patient autonomy and patient voluntary consent are not present, or cannot be obtained, themedical decision making should remain in the hands of the primary physician.
In cases where the patient is not able to give informed consent, or make decisions forthemselves, the primary physician should be adopting a paternalistic approach to the situation. They