Harold is a 57 year old man who has been diagnosed 18 months ago with Motor Neuron Disease. After discussions with his family, neurologist and GP Harold completed a Health Direction (Advanced Care Directive) 6 months ago which clearly states that if his health deteriorates that he does not want specific treatments to prolong his life such as antibiotic therapy and admission to intensive care. Harold has developed a chest infection in the last couple of days. This morning Harold's wife finds him confused and disorientated. She calls an ambulance and he is transferred to the emergency department, a copy of his Health Directive is given to the Ambulance Officers. In the emergency department, Harold is unable to effectively communicate because of his current acute illness. Harold's wife explains to the health professionals that Harold had in recent times come to terms with his diagnosis, and that he was looking forward to the upcoming birth of their first grandchild in approximately 5 months and an interstate family holiday after that. Harold's wife expressed that she thought he would want to be treated for his severe chest infection, as the antibiotic therapy was likely to be effective.

In light of Harold's written direction that refused antibiotics and intensive care treatment (within the Health Direction), analyse and discuss the most relevant ethical and legal considerations that the team of health professionals must assess to determine their next steps.