A Patient’s Right to Refuse Medical Treatment Through the Implementation of Advance Directives

Abstract

Serbia’s legislation on patient rights has largely been formulated in response to contemporary understandings of human rights. But the way in which this legislation has been implemented reveals a misunderstanding concerning the degree to which the rights explicated in the Patient Rights Act (Official Gazette of the Republic of Serbia No. 45. 2013) are applicable to patients receiving palliative care. There are issues particularly pertinent to terminally ill patients, including euthanasia (Article 28) and advance directives (Article 16) which need to be discussed and revised. First, according to the provisions, the term ‘euthanasia’ does not differentiate between passive and active forms of euthanasia, which means that both passive and active euthanasia is forbidden under Serbian law. However, in medical practice, there are situations in which passive euthanasia, e.g. withholding life-saving treatment, is permitted without sanction. The legality of this common practice is called into question by the current formulation of the Patient Rights Act. In practice, this conflict is not visible given the fact that situations like this are interpreted as falling under the patient’s broad right to refuse medical treatment. Second, regarding advance directives, I will argue that, according to Serbian law, a dying patient is entitled to basic rights and human dignity. This entails a right to prepare one’s own advance directive, and to have it respected. Accordingly, provisions to allow for this should be incorporated into Serbian legislation.