The typical persistent-vegetative-state patient can engage in activities such as opening and moving eyes, crying, smiling, frowning, yawning, chewing, swallowing, moving limbs spontaneously without purpose and grunting. Although this behaviour can produce the illusion of voluntary acts, they are not actually so. These are merely reflex response which are compatible with complete unawareness. … It is clear that Mr. Rasouli’s family loves him very much and that they desperately want to believe he was conscious and improving. Unfortunately, it is also clear that this coloured their interpretation of his behaviour.
- Brian Cuthbertson and Gordon Rubenfeld. Mr. Rasouli’s doctors at Sunnybrook Health Sciences Centre, Toronto
The age effect
Older adults and people with disabilities are most likely to be disproportionately impacted by the outcome of this appeal. Common ageist misperceptions include: older adults, by reason of their age, have nothing to contribute to society; older adults have a poor prospect of recovery; and older adults are presumed to be incapable of making treatment decisions. In a society that favours youth and being young, ageism flourishes.
- Advocacy for the Elderly and ARCH Disability Law Centre
Help or harm
When an underlying illness is irreversible, the extended use of critical care can unnecessarily prolong and exacerbate the process of dying. It would unfairly compel physicians to continue care that is no longer medically indicated, contravening their obligation to do no harm and forcing them to practise medicine below the standard of care. … Critical care does not provide a physiological status quo – it is invasive, intrusive and almost always painful and debilitating.
- Canadian Critical Care Society
The common law concerning the withdrawal of life-sustaining treatment remains unsettled and inconsistent. This uncertainty leaves physicians, nurses and families unsure of their legal obligations and rights. … Consent from the substitute decision-maker is necessary to ensure that a patient’s non-medical interests are properly considered. Physicians alone are not, and cannot be expected to be, equipped to fully weigh and evaluate the many factors that comprise a patient’s best interests.
- Canadian Association of Critical Care Nurses