Judge rules patient can refuse amputation

MONTREAL • In a precedentsetting decision, a Quebec court has rejected a request by a Montreal hospital to forcibly amputate the legs and several fingers of a homeless man who suffered from severe exposure.

The patient, identified in the judgment only as K.D., is a 44-year-old native of Togo and was admitted to the Centre hospitalier de l’université de Montréal (CHUM) on Dec. 11 suffering from severe frostbite.

Medical specialists judged amputation was necessary, but the patient, who had been assessed as suffering from mental health problems, refused the procedure.

The hospital went before Quebec Superior Court on Dec. 27 seeking a court order allowing doctors to proceed. However, in a judgment released Jan. 3, Superior Court Justice Gérald Dugré ruled while the patient was not competent to consent to a procedure that will be inevitable, that refusal constituted part of his fundamental rights. The judge also noted “the CHUM has not demonstrated that amputation ... is necessary at the moment.”

“These amputations ... constitute an irreparable violation of the defendant’s person and his right to physical integrity, even if it has been irredeemably compromised after his severe frostbite.”

A patient forced by the courts to undergo the amputation of his legs while he is convinced they can be saved “may keep the unshakable conviction that such a procedure was unnecessary and his wishes had not been respected,” Dugré wrote.

The judge noted also one out of two patients in such situations is a victim of septicemia, a general infection, however the doctors for K.D. had not indicated the probability of such a development in his case.

The court could be approached again should the patient’s health situation change and make an amputation an urgent necessity, the judge ruled.

Neither litigants nor the judge could find any jurisprudence of a Quebec court having to deal with a request for a forced amputation.