Patient launches legal bid to avoid forced amputation in Victoria hospital

A patient who was admitted involuntarily to a Victoria hospital under the Mental Health Act is going to court in a bid to preserve his ability to decide whether doctors can amputate his left foot.

The man, who suffers from diabetes and has experienced diabetic ulcers in both of his feet, is in Royal Jubilee Hospital with a rare but serious infection known as osteomyelitis that doctors say will require them to surgically remove infected bone in his foot or lower leg.

Although he was admitted to the hospital involuntarily, he managed to get the certification under the Mental Health Act overturned earlier this week.

A petition filed in B.C. Supreme Court is the next step for him and will deal with the issue of whether the hospital can go ahead with the surgery without his consent.

“While his medical team had previously decided that the amputation should go ahead even if the patient does not consent, the goal of our court action is to keep the decision-making power in the patient’s hands,” said lawyers Chris Hope and Katherine Shortreed in an email.

“If a patient is capable of understanding and weighing the risks and options for medical treatment, and can communicate his or her decision, that decision should be respected, particularly when it involves a major, life-changing surgery like foot amputation.”

Doctors have told the patient there is a possibility that he might die during surgery and might also die if he doesn’t have the surgery since the infection might spread to other parts of his body.

The patient weighed the options and made a decision that he would prefer not to have the surgery to amputate at this time and would rather seek other possible treatments that would involve him keeping his foot, the petition says.

“The petitioner is not and has not been incapable of giving, refusing or revoking consent to health care by reason of mental or physical incapacity or any other reason,” says the court document.

“Notwithstanding a history of drug use and psychological problems, the petitioner is and has been fully able to understand, comprehend, consider and communicate his wishes to his health-care providers.”

Upon deciding that the patient wasn’t capable of making a decision, the process called for the hospital’s medical team to try to find somebody else to make that decision. Normally a family member or even a close friend might make the decision but in the Victoria case there was no such person available so health authorities turned to the Public Guardian and Trustee of B.C. (PGT), which as a temporary substitute decision-maker gave consent for the proposed surgery. But the PGT’s consent expired April 30, according to the petition.

The PGT said in an email it doesn’t comment on specific cases but noted that the petition doesn’t seek to reverse any decision made by the PGT.