Sure. I think the concern people are expressing is understandable, but I think it absolutely can be dealt with by reflecting on the Carter test, and also in the context of the practice of medicine.
Think about what “informed choice” requires. The individual has to have capacity, under the Carter test, which means they have to understand the nature and the consequences of the decision to be made. In the immediate aftermath of a traumatic injury, physicians will say a person doesn't actually have that yet, so being responsive to that kind of situation is built into the test.
Similarly, you have to be informed. You could argue again that in the immediate aftermath of an injury, you don't yet have the full information about what it is going to be like to live in that way, so you would again maybe not be found to be fully informed.
Under the Carter test, the suffering also has to be enduring. In the immediate days after an accident, no physician is likely to say that the suffering is enduring and that someone therefore meets the test.
The final thing to say in response to this is that physicians already, every day, deal with exactly this kind of scenario in relation to refusals of treatment. You can have somebody who has a traumatic injury, and then they say the kinds of things that Steven Fletcher may have: “I don't want the treatment. I don't want a ventilator. I don't want artificial hydration or nutrition.” We work with the established principles of informed choice and insist that the person have capacity and be informed, and that can take time.
You don't have people losing their ventilator or having antibiotics withheld in the immediate aftermath of a traumatic injury. I'm saying it can absolutely be managed in the context of current practice. We rely on physicians to do that now, and Justice Smith acknowledged this in her trial decision.