Bioethics News

Delusional but autonomous

Can a confused, lonely, bi-polar, sick 73-year-old with religious delusions refuse an operation which will save his life?

Yes, says the UK’s Court  of Protection. A man known as Mr B is a diabetic with a severely infected leg. His life can only be saved if it is amputated below the knee, according to the best medical advice. Without this, he will die of the infection, possibly within a few days. Mr B has no one else in the world to care for him. “He has no next of kin. No one has ever visited him in hospital and no one ever will,” observes the judge.

In the opinion of the judge he does not have the mental capacity to make a rational decisions about his illness. On the other hand, Mr B, who is not afraid of dying and bears his pain with great fortitude, does not agree with the doctors:  

“I don’t want an operation. I’m not afraid of dying, I know where I’m going. The angels have told me I am going to heaven. I have no regrets. It would be a better life than this. I don’t want to go into a nursing home, [my partner] died there. I don’t want my leg tampered with. I know the seriousness, I just want them to continue what they’re doing. I don’t want it. I’m not afraid of death. I don’t want interference. Even if I’m going to die, I don’t want the operation.”.

The next question, then, is what is in Mr Bs “best interests”.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.