Introduction

The law recognizes patients’ right to refuse medical treatment, inclusive of refusing life-sustaining treatment, which could see a patient succumb to illness. According to UK law, a patient that is competent and within the legal age of adulthood has absolute and indisputable right to refuse medical treatment. This reflects the strong and brave recognition of patients’ rights, to the extent that the disregard of a patient will amount to legal actions. The law recognition of patient’s ethics reflects its awareness of patient autonomy, which emphasis on a higher footing the state interest in protecting the health and life of patients. Nonetheless, this does not translate to state negligence of citizen’s lives. Patient autonomy is considered by patient competence since the principle of self-determination is the determining factor for the sanctity of human life.

This paper will argue that patients, specifically the disabled patients have a right to refuse life-sustaining treatment. It explores legal and ethical aspects that support disabled patients decision refusal of life-sustaining treatment. Legal dimensions, Patient autonomy and the competence of the bedridden patient are the key factors that facilitate the patient right to refuse life-sustaining medical treatment.

Exposition

In the history of medical health, patients face a tough choice of deciding whether to undergo medical treatment. They consequently have to balance between the benefits and risks of medical treatment prescribed by health care providers. However, in the current decade, the right to refuse medical treatment, inclusive of life-sustaining treatment is globally accepted by the legal and medical society and recognized patient charters and other government publications.  Nevertheless, disabled patients life is prolonged at all costs without considerations of the risks and benefits of the treatment to the patient. The patients are subjected to life-sustaining treatment without seeking consent due to the assumption that most of the patients are incompetent to make informed medical decisions.

The legal system, however, perceives every person competent to make informed decisions unless proven otherwise. Thus, disabled patients have the capability and the right to evaluate the risks and benefits of life-sustaining treatments, accept or refuse the treatment.  It may be true that patients with intellectual disabilities lack competence, but they have designated surrogate that makes the medical decision on their behalf. The consent of treatment to all patients is critical, and doctors must not dictate medical treatment without approval from a competent patient. Most of the physicians recommend life-sustaining treatment for chronically ill persons which in many cases is futile in terms of patient survival. In that context, it is only fair that all patients, specifically the disabled are allowed to decide on the life-sustaining treatment before administration. The care providers, however, should present the risks and benefits of a treatment, alternatives, and outcomes so that the patient understands the consequences of their decision.

Disabled patients have a right to refuse life-sustaining treatment

Life-sustaining treatment is identified as all possible medical means to prolong a patients’ life from simple to extraordinary measures. In this process, competence is integral to the refusal of lifesaving treatment. However, a line is drawn between unconscious and conscious patients able to understand and evaluate the pros and cons of treatment choices. Based on common law and medical ethics, juries across the world asserted that there are no bases to limit a patient right to decline life-saving treatment to competent patients. It is in this sense that disabled patients have a legal and ethical right to refuse lifesaving treatment. The ethics and the law allow a disabled patient to uphold their rights and protect themselves from potential harm. Thus, disabled patient right to refuse medical treatment as per the ethical and legal principles. The scope of disabled patients to refuse treatment is therefore not only defined by courts across the world in a limited range but has been based on detailed analysis, and broader rights as described by the universal law right of self-determination and the privacy rights and ethical concepts.

The concept of respect of autonomy emphasizes on the consent law and refusal of treatment. Administering treatment to a disabled or any other patient without their consent is recognized as the tort of battery by common law. Nonetheless, legal and valid consent is given to patients with the capacity to make decision or competence. Under the law, the choice of a competent person to refuse treatment should be respected; even though it risks their life or appears irrational.  According to the Mental Capacity Act, (2005), a patient is assumed to have a decision-making capacity unless proven otherwise. This act guides capacity assessment and provides the best actions for patients lacking the ability to balance the risks and benefits of their decisions. The conclusion that a patient cannot consent to treatment should be factual and should reveal a patient inability to understand relevant information on health decision, inability to retain information, and incapability to weigh information in the process of decision making.

It in this context, that disabled patients have a right to consent treatment refusal. Disabled patients have the competence to understand treatment options, pros, and cons and alternatives to healthcare and make and make an informed decision. All patients with a disability can understand the information provided by the physicians, individually or through the help of a surrogate for intellectual disabilities. Disabled patients, therefore can make decisions over their health through a proxy or individually. Thus, it is crucial that competent disabled patients’ decision to refuse life-sustaining treatment be respected even when physicians or the general public view their choice as unreasonable.

Ethical concepts also justify disabled patients refusal for treatment. Ethics in health care are defined by the goals of the care providers and those of a patient. The goals of physicians are prevention, curing, challenge developing illnesses, stabilize conditions and relieve severe symptoms. The goals focus primarily on generating cure to diseases and are not seeking to prolong or preserve patients’ life. Besides, the care providers are not obligated to meet all the goals at once.

On the other hand, the disabled patient has their health and life objectives, in addition to their preferences and values. This means that both the patient and the healthcare provider have the freedom to act and put across their decisions arising from their goals or beliefs. Thus, everyone is mandated to respect the decision of another, regardless of the consequences. Taking responsibility for one own life is the basis of autonomy. The patient generates the rights of health professionals to treat a disabled patient; hence the patient has the right to refuse life-sustaining treatment if it is not among their option. The decision of a patient must not be questioned.

Arguments have challenged the disabled patient choice of life-sustaining treatment, most likely when the decisions seem unreasonable to the physicians and the general public. However, the decision to decline life-sustaining treatment from a competent patient is based on reflection of treatment relevance. This means that even when a decision is unreasonable to many, the benefits calculated by the patient are in proportion to the treatment burden experienced by the patient.

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