Family to take end-of-life fight to Supreme Court of Canada
Published Monday, November 19, 2012 9:00AM EST
A Toronto family is fighting to keep their father alive, going all the way to the Supreme Court of Canada in a battle against a hospital medical team that believes the man is in a vegetative state and will not recover.
Hassan Rasouli has been hospitalized since summer 2010 when a routine surgery for a benign brain tumour left him unconscious, battling a meningitis infection in his brain.
Within weeks, doctors at Toronto’s Sunnybrook Health Sciences Centre determined Rasouli was in a persistent vegetative state (PSV) and said the ventilator that was keeping him alive should be removed.
Rasouli's wife Parichehr Salasel, a family physician in her home country of Iran, refused, saying doctors had given up too soon.
The family has since found ways to communicate with Rasouli, and believes he is responsive and aware, and therefore should be kept alive -- an argument that will be put to Canada’s top court on Dec. 10.
The court ruling comes on the heels of a medical breakthrough in London, Ont., that saw a patient who had been in a vegetative state for more than a decade actually answer questions related to his care based on brainwave analysis. A team of doctors at the University of Western Ontario said last week that they now know 39-year-old Scott Routley isn’t in pain, and are touting the finding as a new way to possibly improve such patients’ quality of care.
Rasouli’s daughter, Mozhgan Rasouli, told CTV's Canada AM that the UWO research -- along with improvements in communication with her father -- has given her renewed hope for his future.
"He is in a minimally conscious state so always, every day, every night we meet him, we sit with him, we talk with him, he's listening to us," his daughter Mozhgan Rasouli told CTV's Canada AM. "Sometimes he's sleeping and we do not interrupt him, then he wakes up and we talk with him, show him his favourite movies and live with him. We have a life with him."
The family first began to see signs of improvement in January 2011, saying Rasouli was tracking their movements with his eyes, and even got to the point where he could give a thumbs-up.
His condition was officially upgraded to "minimally conscious" one year later, in January 2012, due to his responses to external stimulation.
"He can track us, track the movies, track the photos. His eyes are following us," his daughter said. "Actually, I have some exercises with him every day: I try to get him to show me his thumbs up, number one, number two ... With his eyes he has a profound focus."
Rasouli receives around-the-clock care. He breathes with a mechanical ventilator, food is provided through a stomach tube and a catheter drains his bladder.
In their submission to the SCOC, doctors at Sunnybrook said protracted end-of-life care is a massive drain on the entire medical system, arguing that physicians should have the right to decide when life support is halted.
The dedication of such resources affects “the allocation of scarce medical resources in the Canadian medical system, for the cost associated with providing treatment without medical indications risks depriving others who might benefit from medical intervention,” the statement said.
Rasouli has been in intensive care at Sunnybrook for close to two years -- at a cost of up to $2,000 per day.
His daughter said the thing that keeps her going is the unwavering belief that her father is alive and aware, and deserves continued treatment.
"From the beginning we didn't think this case was going to have this long journey and go all the way to the Supreme Court of Canada. From the beginning, we were just going to tell doctors that my father is there and he was there and he is there," she said.
The court's decision could set an important precedent for future end-of-life treatment cases, setting a blueprint for who decides whether to continue treatment indefinitely, or pull the plug.