Do physicians require consent to withhold CPR that they determine to be nonbeneficial?

James Downar, Eliana Close, Robert Sibbald

Do physicians require consent to withhold CPR that they determine to be nonbeneficial?

Key Points

  • The Ontario Superior Court of Justice recently determined that, under both Ontario’s health care consent legislation and common law, physicians do not require consent to withhold cardiopulmonary resuscitation (CPR) that they believe to be medically inappropriate.
  • Physicians in Ontario need to distinguish carefully between a scenario where CPR would be outside the standard of care and should not be offered and a scenario where CPR is within the standard of care but the physician does not feel it is in the patient’s best interests; each scenario demands a different response.
  • Physicians still have a professional responsibility to communicate (or make reasonable efforts to communicate) honestly and compassionately about the limitations of CPR and the alternatives to aggressive care.

Downar J, Close E, Sibbald R. Do physicians require consent to withhold CPR that they determine to be nonbeneficial? CMAJ 2019 Nov 25; 191 (47) E1289-E1290; DOI: https://doi.org/10.1503/cmaj.191196.

Victoria’s voluntary assisted dying law: clinical implementation as the next challenge

Ben P. White, Lindy Willmott, Eliana Close

The Medical Journal of Australia

The Voluntary Assisted Dying Act 2017 (Vic) (VAD Act) will become operational on 19 June, 2019. . . . While some have written on the scope of, and reaction to, the VAD legislation, there has been very little commentary on its implementation. Yet, important choices must be made about translating these laws into clinical practice. These choices have major implications for doctors and other health professionals (including those who choose not to facilitate VAD), patients, hospitals and other health providers. This article considers some key challenges in implementing Victoria’s VAD legislation.


White BP, Willmott L, Close E. Victoria’s voluntary assisted dying law: clinical implementation as the next challenge. Med J Australia. 2019 Mar;210(5):207-209.e1