n South African Journal of Criminal Justice - Pacemakers and 'living wills' : does turning down a pacemaker to allow death with dignity constitute murder?

Volume 18, Issue 1
  • ISSN : 1011-8527
  • E-ISSN: 1996-2118



Recently the death of a dying comatose patient was prolonged by about 60 hours before a medical practitioner could be found who was prepared to turn down the pacemaker even though the patient had made a living will stating that he did not want to be kept alive by 'artifi cial means' or with 'artifi cial support'. <br>This paper deals with the meaning and status of 'living wills'; the right of patients to refuse medical treatment; whether the words 'artifi cial means' and 'artifi cial support' in a 'living will' include pacemakers; and the legal position when turning down the pacemakers of 'brainstem dead', persistent vegetative state, and comatose non-persistent vegetative state, patients. <br>The paper concludes that a doctor who turns down the pacemaker of a patient who is brainstem dead or in a hopeless persistent vegetative state may not be charged with murder. A doctor who turns down the pacemaker of a comatose patient may or may not be charged with murder -- depending on the circumstances. In order to obtain a proper informed consent doctors should discuss end-of-life decisions with their patients, including the advisability of making a 'living will'.

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