CYIL vol. 13 (2022)

CYIL 13 ȍ2022Ȏ

FUTILE MEDICAL CARE: CHILDREN, PARENTS AND COURTS

FUTILE MEDICAL CARE: CHILDREN, PARENTS AND COURTS Tomáš Holčapek

Abstract: Modern medicine has its limits, and in some cases, doctors may come to the conclusion that there is nothing more which they can do to meaningfully benefit the patient, apart from palliative care and support of the patient and their family during the final days. When such cases involve children they are particularly sensitive because parents usually want to help their child at all costs and may wish to prolong care or request experimental therapeutic methods, even if it promises very little from the objective viewpoint. The doctors may intend to end curative care, sometimes even turn off the life-support systems; the parents may strongly oppose it. When such a conflict arises, it easily transposes into a legal dispute and courts may get engaged. How should such conflicts be approached and resolved by the judiciary? The article discusses several selected cases which illustrate the critical issues, and formulates some general observations which transcend particular national legal systems. Resumé: Moderní medicína má své meze. Lékaři někdy dospějí k závěru, že pro prospěch pacienta již nemohou udělat nic jiného než poskytnout mu paliativní péči a podporu jemu i jeho rodině v závěru života. Když se takové případy týkají dětí, jsou zvláště citlivé. Rodiče zpravidla chtějí svým dětem pomoci za jakoukoli cenu a mohou usilovat o prodloužení péče či se domáhat nasazení experimentálních terapií, i kdyby se objektivně jevily jako velmi málo nadějné. Lékaři mohou chtít kurativní péči ukončit, někdy i včetně vypnutí přístrojů udržujících pacienta při životě; rodiče tomu mohou chtít bránit. Vznikne-li takový konflikt, může se snadno přenést do roviny právního sporu a dospět k soudu. Jak by takové spory měly být řešeny soudním systémem? Článek se zabývá několika vybranými případy, které ilustrují problematické aspekty, a dospívá k obecnějším závěrům, které překračují rámec konkrétních právních řádů. Key words: futile care; ineffective medical care; termination of life-sustaining treatment; minors; parents; courts; judicial review About the Author: JUDr. Tomáš Holčapek, Ph.D. is a member of the Department of Civil Law and of the Department of Health Law at the Law Faculty, Charles University, Prague, Czech Republic. He teaches civil procedure and health law. This article was written with support of the Technology Agency of the Czech Republic in the project Právní nástroje podpory inovací v medicíně [ Legal Tools in Support of Innovations in Medicine ], project id. no. TL03000688. Introduction Most of us would wish that medicine was all-powerful. Fear of illness and death is something known very well by human beings. Although death is certain for us, we often wish to delay it, and we only come to accept it very reluctantly. Losing a family member, especially a child, is a very sad experience. And so we would like the doctors to be able to defeat any injury or illness. Unfortunately, this cannot be. While modern medicine has advanced very far, it still has countless limits. Sometimes nothing meaningfully beneficial can be done for the patient. The patient, and those around him or her, may attach their hopes to a new,

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