In the Medical Journal of Australia, check out "Withholding and withdrawing life-sustaining treatment in a patient's best interests: Australian judicial deliberations" by Lindy Willmott, Ben White, Malcolm K Smith and Dominic J C Wilkinson.
They identify six key themes from the developing body of Australian Supreme Court jurisprudence about life-sustaining treatment decisions for adults who lack capacity:
- Futile medical treatment is not in a patient's best interests.
- Treatment that is overly burdensome is not in a patient's best interests, even if the patient is unconscious or unaware of treatment burdens.
- Courts have generally not engaged expressly in quality-of-life assessments, but they remain relevant for determining best interests when considering the patient's medical condition and prognosis.
- A patient's wishes and values (gleaned when the patient was competent) are relevant to, but do not determine, his or her best interests. Family members' views may also be relevant where they are reflecting a patient's wishes, and perhaps also when reflecting their own wishes, but these views are not conclusive in determining a patient's best interests.
- The interests of other people and organisations (including the wider health system) are generally not relevant when determining a patient's best interests.
- Courts have generally deferred to medical practitioners' opinions about treatment decisions, even when the patient's family has strongly opposed them.
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