First of all, Hospital has the duty to treat patients. However, a hospital
will still need the consent of the patient before the medical team could
proceed with the treatment. In the case of Re:C (adult,refusal of treatment)
1994 1 WLR 290, Heatherwood Hospital act as the medical team and C is the
patience. C was seen to have severe gangrene in his foot. The consultant
vascular surgeon at Heatherwood Hospital had informed C regarding the risk and
consequences of no treatment. The chance of living with only conservative
treatment is only 15%. However, C stated that he would rather die with two feet
than live with one foot.
The rule used to analysis the issue by Heatherwood Hospital is different
from how C analyse the situation. Heatherwood Hospital had used Utilitarian or
the outcome base rule to analyse the situation. Heatherwood Hospital had
applied the outcome base theory, the hospital had made a decision that promotes
more happiness. By putting both outcome whether to treat by giving more chance
of surviving to C or not to treat, to fulfil C wishes of keeping both his feet
but with a very low chance of survive, as low as 15%. Heatherwood Hospital had
given an advice C to go through the amputation, for the best interest of their
Nonetheless, as the medical personnel, they could only inform the
patient of any risk and consequences of not taking the treatment. Besides, the
hospital has to give C ample time to make his decision and be sure that C is
giving consent voluntarily. At the end of the day, the patient will still have
the full right to make a decision and shall be fully respected.
In the other hand, C had applied character base theory to analyse the
situation. Character based ethics often referred as virtue ethics, is the
decision of a personal preference rather than a good action. From the angle of
character base ethical approach, C had strongly insisted to keep both his feet
than to amputate one of it. Even though by amputating the gangrene foot could
give him a higher chance of living, but he didn’t see the happiness of living
with only one foot if so, he would rather die with two feet.
In addition, C had even applied to the court for an injunction to stop
the hospital to carry out the amputation. C had received the injunction granted
from the Family Division of the High Court to stop any amputation by
Heatherwood Hospital or any other hospital in future without C’s written
With the strong will of C to keep his foot, the hospital has made an
additional step to assess the patient’s condition and capacity to understand
the nature of treatment. The hospital’s consultant forensic psychiatrist felt
that C was not capable of going through all the mental stages of consenting to
or refusing the amputation. By referring to C medical record, as previously he
was diagnosed as a chronic paranoid schizophrenic and yet fully recover to
normal yet. In my point of view, as C is suffering from having hallucinations,
particularly of auditory variety, and perceptual disturbance since he was
diagnosed with chronic paranoid schizophrenic when he was in prison. These symptoms can have a huge effect on functioning and can
negatively affect the quality of life. In another word, the most important
condition before a person could sign a medical consent is to be sure that the
person has a free mind of thoughts. But, C could have got some disturbance by
hallucination and auditory variety.
I personally would prefer to have utilitarian, outcome based approach.
It is beneficial for both parties. Decision-making power should be given to the
Hospital as they as medical personnel is the medical professional, they must
have known better than anyone of us. Furthermore, C didn’t have a clear mind on
the decision making process.
At the end of the day, will C be granted the injunction to stop
Heatherwood Hospital or any other hospital to do the amputation is ultimately
rely on the court. If I were the judge in this case, I wouldn’t have grant the
injunction. Reason being, C might have taken this opportunity as a nicer way to
end his life. From the case report, we understand it is not easy for C to get
through a seven years sentence.