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Withholding and withdrawing life-sustaining treatment in a patient’s best interests: Australian judicial deliberations

What should doctors do if they cannot reach agreement with a family about life-sustaining treatment for an adult who lacks decision-making capacity? Effective conflict-resolution strategies generally resolve these disputes and intractable conflict is rare.13 But when such disputes occur, they are stressful for clinicians, families and patients. Health professionals can experience moral distress, with significant personal and professional impact.1,4 In such cases, or where there are concerns about the lawfulness of proposed conduct, medical practitioners or their hospitals may need to seek a court or tribunal opinion.1,5,6 Concerned family members may themselves seek a judicial intervention.

Although all Australian states and territories have adult guardianship tribunals,7 Supreme Courts retain an important role in this field. They have jurisdiction to resolve end-of-life disputes, and their decisions provide authoritative guidance for guardianship tribunals and clinicians in their deliberations. Supreme Courts apply the test of whether the proposed treatment is in the patient’s “best interests”,…