CPR and ventilation
Resuscitation, mechanical ventilation and other intensive-care interventions that may keep the body alive.
Withholding or Withdrawing Life-Sustaining Treatment
Your right to refuse or stop treatment that no longer reflects your wishes.
Life Support Decisions
Clear choices, made with dignity and care
South African law protects a person's right to make informed decisions about healthcare. That includes the right to refuse treatment and, in appropriate circumstances, to ask that life-sustaining treatment not be started or not be continued.
These decisions are often emotionally difficult, especially when a family is facing crisis, uncertainty or conflict at the bedside. The aim is not to abandon care. It is to ensure that medical treatment respects the patient's values, wishes and legal rights.
DignitySA encourages people to document their wishes, appoint a trusted decision-maker in writing, and speak openly with loved ones and healthcare providers before a crisis occurs.
Plain language
What kinds of treatment may be involved?
Life-sustaining treatment can include any intervention that keeps the body alive when a person's condition is serious, irreversible or uncertain.
Dialysis and procedures
Ongoing or emergency interventions such as dialysis, surgery or invasive procedures where benefits and burdens must be weighed.
Artificial nutrition and hydration
Tube feeding, drips and other medically provided nutrition or hydration when a person cannot eat or drink normally.
Any health service
The National Health Act frames consent broadly. A patient may refuse a health service after being properly informed.
Legal foundation
The National Health Act starts with informed consent
The current DignitySA guidance is grounded in Sections 6 and 8 of the National Health Act of 2003.
Health services need informed consent
Section 8 of the National Health Act says a health service may not be provided without the user's informed consent.
Patients must be properly informed
Section 6 requires information about health status, treatment options, procedures, risks, likely benefits and the implications of refusal.
Refusal is a legitimate choice
The Act expressly recognises the right to refuse health services, provided the person understands the implications of that refusal.
Care must continue
Withholding or withdrawing a treatment does not mean abandoning care. Comfort care, symptom relief and palliative support remain essential.
Who may speak on the patient's behalf?
If a patient cannot give informed consent, the law recognises people who may consent or refuse treatment on their behalf. A written mandate is the clearest way to avoid confusion and conflict.
Mandated persons and legally recognised next of kin are empowered to make medical decisions about withholding or withdrawing life-sustaining treatment. Their lawful decisions should be respected as if the patient were making the decision.
Download mandate templatesThe patient, if they are capable of making and communicating an informed decision.
A person mandated in writing by the patient, such as through a Section 7 Mandate.
A person authorised by law or court order.
If no one has been mandated or authorised, the statutory family order: spouse or partner, then parent, grandparent, adult child, brother or sister.
Communicate wishes before decisions become urgent
Written wishes are most useful when they are part of an ongoing conversation with loved ones and healthcare practitioners. Wishes are context-specific and can change over time, so advance directives should be reviewed and discussed, not simply filed away.
A living will can give evidence of what a person would have wanted. A Section 7 Mandate appoints someone trusted to make healthcare decisions if the person cannot.
What does quality of life mean to me in practical terms?
Which treatments would I accept if they could restore me to an acceptable level of wellbeing?
Which treatments would I refuse if they only prolonged dying or severe suffering?
Who should speak for me if I cannot communicate?
Where are my signed documents stored, and who has copies?
When rights are not respected
Ask for clarity, documentation and support
If there is uncertainty or disagreement, ask the treating team to explain the patient's condition, the proposed treatment, the likely benefits and burdens, and the consequences of refusing or stopping treatment. It can also help to request a family meeting, palliative care input, or a senior clinical review.
If you need support with the enforcement of rights to withhold or withdraw life-sustaining care, contact DignitySA and we will do our best to point you in the right direction.
Guidance by audience
Find the right next step
These pathways connect life support decisions with the practical resources already gathered for patients, families and medical professionals.
Advance directive templates
Download DignitySA templates for a living will and Section 7 Mandate.
For families
Guidance for relatives and mandated decision-makers supporting someone who cannot speak for themselves.
For medical professionals
Clinical and ethical guidance on consent, mandated decision-makers and withdrawal of treatment.
Palliative care support
Find palliative care services and support for patients, families and caregivers.
Important Distinction
This is not assisted dying.
Refusing, withholding or withdrawing treatment allows the underlying illness or condition to take its course. It should always be accompanied by appropriate comfort care, symptom relief and support.