WITHHOLDING OR WITHDRAWING MEDICAL TREATMENT FROM SEVERELY ILL NEONATES IN MALAYSIA: REGULATORY GAP AND UNCERTAINTY

Abstract

There are various circumstances that require medical practitioners to decide to withhold or withdraw medical treatment from severely ill or impaired neonates. Not only is it ethically complex to make such a difficult decision, but they may also be exposed to legal liabilities. Therefore, it is crucial for medical practitioners to have access to comprehensive guidance and legal rules. Unlike jurisdictions such as the UK and the Netherlands, which have specific legislation, guidelines, and legal precedents that serve as points of reference, there is a gap in Malaysia’s regulatory system, surrounded by a climate of uncertainty. Based on qualitative and doctrinal studies, this article highlights the regulatory gap as well as selected case laws in the United Kingdom that can be used to reform the existing decision-making mechanism in Malaysia to protect doctors who decide to withhold or withdraw medical treatment from critically impaired neonates. This article argues the existing national clinical guidelines, which play an important role as the sole guiding document for Malaysian medical practitioners, lack comprehensive and clear guidance. This is compounded by the lack of clarity regarding the legality of withholding or withdrawing medical treatment from severely ill neonates, as there is no specific legislation or case law regulating this area. The Child Act 2001 and the Malaysian Penal Code are the two relevant legislations that shed some light on this issue and reflect the regulatory gap between the national clinical guidelines and the legal framework. Hence, amendments to the Malaysian Penal Code and the Child Act 2001, together with improvements to the clinical practice guidelines, are needed to strengthen the regulation of withholding or withdrawing medical treatment from severely impaired neonates in Malaysia.