What determines if a treatment should be withheld or withdrawn?
Code of Medical Ethics Opinion 5.3 While there may be an emotional difference between not initiating an intervention at all and discontinuing it later in the course of care, there is no ethical difference between withholding and withdrawing treatment.
In what circumstances are medical treatments not indicated?
In what circumstances are medical treatments not indicated? No scientifically demonstrated effect. Known to be efficacious in general but may not have the usual effect on some patients because of their presentation of the disease or their constitution.
What does it mean to withdraw a treatment?
In general, treatment is withdrawn when death is felt to be inevitable despite continued treatment. This would typically be when dysfunction in three or more organ systems persists or worsens despite active treatment or in cases such as multiple organ failure in patients with failed bone marrow transplantation.
When do you decide to withdraw from life support?
It is best when all the patient's loved ones can agree on whether to withhold or withdraw life support. When the medical situation clearly points in a certain direction, this is more likely. If a unanimous decision can't be made, it may be helpful to try mediation.
What is the difference between withdrawing and withholding medical treatment?
Such decisions can essentially take one of two forms: withdrawing – the removal of a therapy that has been started in an attempt to sustain life but is not, or is no longer, effective – and withholding – the decision not to make further therapeutic interventions.
When is a treatment considered medically futile?
“Futility means any treatment that, within a reasonable degree of medical certainty, is seen to be without benefit to the patient, as when the treatment at issue is seen as ineffective with regard to a clinical problem that it would ordinarily be used to treat.”
Who makes the decision to withdraw treatment?
Making the decision to withdraw treatment This decision will be based on what your best interests are believed to be. Your healthcare team will discuss this with your family members and your lasting power of attorney (if you have one), giving them time to consider all the implications.
Is Withdrawing treatment legal?
In the United States, the withholding and withdrawal of life support is legally justified primarily by the principles of informed consent and informed refusal, both of which have strong roots in the common law.
What does it mean when a patient is withdrawn?
What Is Withdrawal? Withdrawal is the combination of physical and mental effects that a person experiences after they stop using or reduce their intake of a substance such as alcohol and prescription or recreational drugs.
When is it justifiable to discontinue life sustaining treatment?
When is it justifiable to discontinue life-sustaining treatments? If the patient has the ability to make decisions, fully understands the consequences of their decision, and states they no longer want a treatment, it is justifiable to withdraw the treatment.
Can a hospital remove life support without family consent?
Under existing law, a patient who has the capacity to decide may refuse any treatment, even if the result is certain death. Doctors cannot carry out treatment without a patient's consent, if the patient is able to give it.
Clinical Decisions
When to Withhold
- Treatments often carry risks, and a doctor needs to weigh up the balance between the potential for doing good and the potential for harm. People who are refused anti-biotics when they have a sore throat often feel let down, but the doctor has been weighing up the small chance of the drugs making any difference, against the very real risk that over-use of antibiotics can lead to resistan…
Respecting People
- Christians base treatment decisions on the fundamental principle of respect for the sanctity of human life. This is not altered if a person is very old or very young, physically able or has severe disabilities. For example, a recent discussion document from the British Medical Association says that the association 'finds unacceptable' the practice whereby people with conditions like Down'…
Best Interest
- One common guide is to look for the patient's 'best interest'. This can help when treating young children, or adults who are not fully conscious. In the past, best interest was almost always seen as prolonging life. However, a more complex assessment is needed now that medical technology can keep a person's body alive, perhaps inappropriately. Most people accept that there is no abs…
Double Effect
- Some doctors and lawyers argue that a treatment has a double effect. Pain-killing drugs given to cancer patients relieve suffering, but on occasions they also accelerate their death. This so-called 'double effect' is seen as being acceptable as the intention was not to kill the patient, but to reduce his pain. The phrase 'double effect' is unfortunate in that it suggests that two things were intend…
Laws and Guidelines
- The legal profession is increasingly being asked to give rulings about medical practice. While it is good that medical practice should be legally sound, there are dangers in having to get every difficult decision backed by a court ruling. To start with, in many cases the time taken to get a court decision would be too long and cause more harm than good. At the same time, doctors ar…