The Relevance of Common Law Principles: Addressing the Lacuna

This chapter examines the relevance of common law principles in addressing the lacuna in Malaysian law on end-of-life decisions. Building on the ethical discussion in the preceding chapter, it considers how courts in the UK and Australia have given legal form to difficult questions concerning autonomy, sanctity of life, medical futility, best interests and the protection of vulnerable patients. The chapter begins by analysing active euthanasia and assisted suicide, highlighting the continued common law distinction between respecting a competent patient’s refusal of treatment and intentionally assisting death. It then considers the legal justifications for withholding and withdrawal of life-sustaining treatment, including the act-omission distinction, the assessment of best interests and the doctrine of double effect. The discussion further examines the role of professional guidance, statutory developments and culturally sensitive care pathways in translating these principles into clinical practice. It concludes that the UK and Australian experiences are not to be applied without qualification but provide useful points of reference for Malaysia, where judicial authority remains limited and clearer legal standards are still needed to support ethical and lawful end-of-life decision-making.