Recovery of a Comatose Patient Sets Stage for Confrontation Between Judiciary and Doctors in Canada

by Medindia Content Team on Nov 25 2007 10:52 AM

A 66-year-old Canadian miraculously came out of coma, defying all prognosis. But he has also unwittingly triggered a confrontation between the judiciary and doctors as it was the court that ordered that life-support system not be withdrawn.

Who is to decide at such crucial moments, judges or doctors is the question now.

Zongwu Jin, 66, fell into a coma at the Foothills Hospital in the Calgary province September after falling and hitting his head. Doctors felt his brain injury was so traumatic that they issued a "do not resuscitate" (DNR) order with the agreement of the patient's family.

"The doctors were of the view that the condition was hopeless. They argued that taking steps to resuscitate Mr. Jin could potentially cause him considerable harm," said Sabri Shawa, lawyer for the Jin family.

"We talked to him, tried to say goodbye," recalled Jin's niece Linda Cai. "We saw tears dropping from his eyes."

Eventually Jin's family changed their minds, but doctors refused to lift the DNR order. His daughter was worried Jin could die before she could seek independent medical advice so she sought legal intervention.

A Court of Queen's Bench judge called it an extraordinary situation and awarded the family a temporary injunction, which lifted the DNR order.

And Dame Luck smiled on Jin. He has since made a remarkable recovery, now able to speak, write and read, even though he is still going through rehabilitation.

Still the question of who could be the arbiter of lives, as it were, remains. The Calgary Health Region is fighting the court order.

While giving his directions, Justice Sheilah Martin acknowledged the law was unclear on whether the final say in such cases lay with families or doctors.

Apparently the question has to be reworded, judges or doctors.

"This is a difficult issue for health-care providers all over the world, at least in the western world, and it's one that we're going to have to come to grips with over the next few years," said Jack Davis, the region's president and CEO.

Juliet Guichon, a medical ethicist at the University of Calgary, said the appeal had major implications.

"If the courts were to say, 'Yes, we decide on do-not-resuscitate orders, not physicians,' then we would have to create a whole new structure because judges would have to be available day and night, around the clock to make the decisions that physicians are making."