SA LAW COMMISSION CONCERNING ITS INVESTIGATION

Issued by: SA Communication Service

The South African Law Commission has released a discussion paper dealing with euthanasia and the artificial preservation of life for general information and comment.

The advances made in medical science and especially the application of medical technology have resulted in patients living longer. For many patients this signifies a welcome prolongation of meaningful life, but for others the result is a poor quality of life which inevitably raises the question whether treatment is a benefit or a burden.

According to the present position in our law it is unlawful to terminate a person's life in order to end his or her unbearable suffering even if it is clear that death is inevitable and that the person is about to die. The intentional termination of such a person's life remains punishable even if the suffering person expresses the wish to die or even begs to be killed. Withholding or withdrawing of life-sustaining medical treatment from a patient who is terminally ill may however be permissible under specific circumstances and subject to certain conditions.

In most Western countries increased importance is being attached to patient autonomy. The need has therefore arisen to consider the question whether a mentally competent, but terminally ill patient's right to refuse life-sustaining medical treatment or to receive assistance in ending his or her life should be protected. The position of the incompetent patient as well as the patient who is clinically dead has to be clarified as well.

The Commission is consequently considering proposals for possible law reform with regard to the following matters:

• The circumstances in which it would be lawful for a medical practitioner to withhold all further life-sustaining treatment of a patient who has been certified as being braindead and who is being kept alive artificially.

The right of a mentally competent person to refuse any life-sustaining medical treatment even though such refusal may cause or hasten his or her death.

• The right of a medical practitioner responsible for the treatment of a terminally ill patient to alleviate pain and distress by increasing the dosage of medication to be given to the patient even if the secondary effect of the medication may be to shorten the patient's life.
• Whether it would be lawful for a medical practitioner to actively assist a terminally ill, but mentally competent patient to die by administering or providing a lethal agent.
• Clarification of the legal position with regard to the wishes of the patient as expressed in a so-called advance directive (living will) or power of attorney and the continuing validity of a power of attorney after the principal has become mentally incompetent.
• Those instances in which the chief medical practitioner of a hospital or clinic may, in the absence of a directive of the patient or his agent decide to discontinue the treatment of the terminally ill patient.
• The powers of the court with regard to withholding or with- drawing of medical treatment or performance of any medical procedure which would have the effect of terminating a patient's life.

The Commission has stated the abovementioned issues objectively and neutrally without making specific recommendations. The issues raised need to be debated thoroughly. Based on the outcome of these discussions a report and if it is deemed necessary proposed legislation will be submitted to the Minister of Justice. The comments of all parties which feel that they have an interest in this topic or may be affected by the type of measures discussed in this paper are therefore of vital importance to the Commission.

Written comments or suggestions should reach the Commission by 30 June 1997 at the address given below.

The discussion paper is obtainable free of charge from the Commission on request. (Contact person: Mrs P Kotze). The discussion paper has already been dispatched to interested persons and bodies. The Commission will receive further requests for copies of the discussion paper with effect from 21 April 1997 from interested parties who do not appear on the Commission's mailing list.

Correspondence should be addressed to:

The Secretary South African Law Commission Private Bag X668 PRETORIA 0001

Tel: (012) 322 6440 Fax: (012) 320 0936 E-mail: salawcom@cis.co.za A LAW COMMISSION, PRETORIA DATE: 10/4/97

CONTACT FOR ENQUIRIES IN RESPECT OF MEDIA STATEMENT" A M LOUW (012) 322-6440