Mandela’s family may face quandary over end of life
‘I’m less anxious than I was a week ago,’ Graca Machel tells Johannesburg radio
Such a law was presented before parliament in 2000 but drew little support and was, as a result, ignored by the Ministry of Health after Mr Mandela had left office, Willem A Landman, executive director of the Ethics Institute of South Africa wrote last year in a paper called “End-of-Life Decisions, Ethics and the Law”.
Even the passage of the Health Care Act of 2003, which for the first time in South African law provided a definition of death - the cessation of all brain activity - did not clear up those legal issues. The law does give doctors the ability to remove a patient from life support, even without a family’s consent, if a patient has a living will and if brain activity has ceased, said Pieter Carstens, head of the Department of Public Law at the University of Pretoria and an expert on legal medical issues.
“It becomes problematic if one seeks consensus by way of an entire family if the patient is not brain-dead but in a permanent vegetative state without a living will or other directive,” Carstens wrote in an email. “It’s uncharted territory,” agreed Meyersfeld, of the University of the Witwatersrand. Sometimes in such highly personal matters in South Africa, there is conflict between what the courts require and what traditional customs prescribe. But in this case, the two worlds agree. “There is no specific customary law that speaks directly to this,” said Gasa, the political analyst. “What is sometimes the practice is that the clan gathers and there is a very simple discussion about how their beloved should be eased from suffering.”
If no consensus is possible and the medical team is convinced that lifesaving measures should cease, Carstens said, he would advise doctors to seek a court order. Whether any medical team would dare to do so in the case of a figure like Mandela is an open question.
“You want to make sure that everybody is comfortable, that is the goal,” Gasa said. “But is that possible in this case? That is the question. Can this be done now?”