Law Commission's report makes no provision for dissenting doctors

BMJ 1995;310:1604-1605 (17 June)

Letters

Law Commission's report makes no provision for dissenting doctors

EDITOR,--There is more to some advance directives than the extensionof autonomy by a once competent patient. That of the VoluntaryEuthanasia Society, for example, requires that insulin is withheldwhen required from a signatory who develops presenile dementia.If that advance directive were legally enforceable the doctorwould have to give way to a patient's wish to have death broughtforward by unreasonable measures.

Len Doyal¹ does not mention a serious deficiency in the LawCommission's draft legislation--namely, the lack of any provisionfor a doctor to dissent for medical or moral reasons from implementingan advance directive. If the document cannot require doctorsto act unlawfully, as the Law Commission claims, then it shouldnot require them to act unethically either.

Practical problems can be foreseen: a patient who has takenan overdose may have signed an advance directive stating "donot resuscitate," or a directive stating "I . . . [Full text of this article]

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