Vancouver hospital can take man off life support, B.C. Supreme Court judge rules

A B.C. Supreme Court judge has ruled that a Vancouver hospital can take a 65-year-old man off life support almost three months after he suffered a heart attack.

The case ended up in court after the daughters of Leo Edward Bikus sought an injunction that would continue his treatment at St. Paul's Hospital.

In a written decision posted Thursday, Chief Justice Christopher Hinkson ruled it would be inappropriate for the court to interfere with the clinical judgment of the patient's physicians, all of whom unanimously agreed that it would be in Bikus's best interests to end treatment. 

According to the decision, Bikus had a cardiac arrest on May 18 that left him without a pulse for 46 minutes and resulted in a lack of oxygen to the brain.

Later that day, the decision said, he underwent an angioplasty and was admitted to the cardiac intensive care unit at St. Paul's. He has since remained on life support, including a breathing machine and a feeding tube. 

His two daughters, Evangeline De Châtillon and Elise Bikus, are entitled to act as his temporary decision makers.

In seeking an injunction to continue their father's life support treatment, the daughters claimed he has shown increased movement and increasing consciousness during his coma.

However, the court ruling cites at least nine physicians who each came to the same conclusion after assessing Bikus.

The physicians, among them cardiologists and neurologists, concluded that continuing the care "would simply prolong his life and be futile, leading to a persistent vegetative state, with no conscious awareness, and would likely result in further harm including bed sores, infection and other complications."

Daughters argue father moved feet

De Châtillon and Elise Bikus questioned the assessment of their father's condition, saying they witnessed their father move his feet and other limbs. 

According to the ruling, several physicians have acknowledged those movements but they believe they are reflexes and not evidence of conscious movement.

On June 2, Bikus's daughters filed a notice of civil claim. They asked for St. Paul's to continue the treatment and for a three-week extension to give them time to get "an unbiased and independent review of their father's circumstances from professional neurologists."

Several hearings followed in July during which different judges granted the daughters' extensions to find a medical expert to review their father's medical records.

After failing to secure an independent medical opinion by Aug. 1, Hinkson denied the fourth request for an extension. 

The judge ruled that because of Bikus's incapacity, the court had jurisdiction to make an order to further his best interests.

"It is clear that there is no medical opinion before me that suggests that Mr. Bikus's neurological prognosis is anything other than extremely poor," wrote Hinkson. "There is evidence that continuing treatment would be harmful as it puts Mr. Bikus at risk of infections, ulcers, sepsis and further complications."

The Aug. 3 ruling gives the acting medical staff of Providence Health Care Society, which operates St. Paul's Hospital, the authority to transition Bikus to a comfort care treatment plan and to discontinue any life-sustaining treatment or health care services within 24 hours of the order being signed by the judge.