1(a). Right to consent to/refuse treatment
A patients right to consent to
or refuse medical treatment has been well
established for decades. A competent patient
has the right to be fully informed about
what treatments are available and the
benefits and burdens of each. The patient
has the final decision about accepting
or rejecting treatment, even against medical
In the early 1900s, most people died suddenly, and death usually
occurred at home. As medical treatment advanced in the 1900s, however,
more and more often death came at the end of lingering or chronic
illness or disease. By mid-century most deaths occurred in institutions.
Artificial life-sustaining treatments began to be used routinely
on patients who were no longer able to state their wishes.
As the century progressed, many people became aware that treatments
which could result in miracles in cases where there was hope, could
also result in grotesquely prolonged and undignified deaths when
used in hopeless situations. Medical providers who recognized the
futility of heroic measures in some cases were caught in situations
in which patients were unable to make or communicate decisions and
family members were divided or ill-informed.
People began to demand ways to state
in advance their desire not to receive
futile and unwanted treatment if they
became unable to speak for themselves.
Gradually the idea of making choices in
advance gained acceptance.