The goal of withdrawing life sustaining treatment is to remove treatments that are no longer desired or do not provide comfort to the patient. 2. The withholding of life-sustaining treatments is morally and legally equivalent to their withdrawal.
Is it unethical to discontinue life-sustaining medical treatment of a patient?
Even if the patient is not terminally ill or permanently unconscious, it is not unethical to discontinue all means of life-sustaining medical treatment in accordance with a proper substituted judgment or best interests analysis.
What is withdrawal of Life-Sustaining Treatment?
Withdrawal of life-sustaining treatment is a process that "merits the same meticulous preparation and expectation of quality that clinicians provide when they perform other procedures to initiate life support".
What is considered life-sustaining treatment?
Life-sustaining treatment is defined as mechanical ventilation, renal dialysis, chemotherapy, antibiotics, and artificial nutrition and hydration. Patients need to understand both the risks and benefits of artificial nutrition and hydration (390).
When should end-of-life issues be discussed with patients?
Summary: Discussions of end-of-life issues early in the course of a patient's health care will contribute to the healthcare team's understanding and respect of the patient's wishes.
What is withdrawal of life sustaining treatment?
1. The goal of withdrawing life sustaining treatment is to remove treatments that are no longer desired or do not provide comfort to the patient. 2. The withholding of life-sustaining treatments is morally and legally equivalent to their withdrawal.
Do patients have the right to refuse life sustaining treatment?
Under federal law, the Patient Self-Determination Act (PSDA) guarantees the right to refuse life sustaining treatment at the end of life.
What is the difference between withholding and withdrawing life sustaining 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.
What is life sustaining procedure?
Primary tabs. A life-sustaining treatment, also referred to as a life-sustaining procedure or life-prolonging procedure, is a treatment utilized to prolong or sustain life without reversing the underlying medical condition.
What criteria would you use to determine whether to terminate 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.
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.
When should I stop 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.
What are examples of life-sustaining treatment?
Patients may consider many life-sustaining treatments; in addition to cardiopulmonary resuscitation (CPR), options include elective intubation, mechanical ventilation, surgery, dialysis, blood transfusions, artificial nutrition and hydration, diagnostic tests, antibiotics, other medications and treatments, as well as ...
What are considered life-sustaining medications?
The FDA defines life-sustaining drugs as a product that is “essential to, or that yields information that is essential to, the restoration or continuation of a bodily function important to the continuation of human life.”
What happen if life sustaining treatments are continued?
What happens if life-sustaining treatments are continued? These treatments can help extend your life. But they will not cure your illness. If you are near the end of your life, you may find it hard to handle the side effects and problems that can occur with these treatments.
Should unilateral decisions be avoided?
Unilateral decisions and overruling of objections should be avoided when possible , and reinforced by legal or ethical authorities when necessary. An ethics consultant, especially one skilled and experienced in management of end-of-life issues, can be a helpful negotiator and guide.
Is withdrawal of life sustaining treatment ethical?
Withdrawing life-sustaining treatment: ethical considerations. In the community of caregivers, there is a general consensus that some heroic measures are not obligatory in certain circumstances that are defined by professional norms. For example, cardiopulmonary resuscitation in terminal cancer patients is not endorsed because of its violation ...
Why was withdrawing medical treatment controversial?
The controversy over withdrawing medical treatment came about because of a new medical condition. This new diagnosis was necessary because of the improvement in medical technology. Before the 1970s, when a patient experienced a cardiac arrest or cessation of heart function, they were simply declared dead.
Who challenged the hydration and artificial nutrition of a patient?
The hydration and artificial nutrition of a patient was challenged in the 1980s by the parents of Nancy Cruzan , a twenty-six-year-old woman who was involved in an automobile accident in 1983.
What is the tragedy of Terri Schiavo?
The tragedy that surrounded Terri Schiavo highlighted the need for legislation and guidelines that physicians, hospitals, and courts can use to ease the complicated nature of these kinds of cases. Legislatures are inconsistent and do not have clear rules on the issue. Instead most have a collection of court decisions and opinions, none of which provide a consistent standard for dealing with a patient in a persistent vegetative state.
What is the issue withholding of treatment for infants with disabilities?
The withholding of treatment for infants with disabilities and other problems has long been a controversial issue. As smaller and smaller premature infants began to survive, the issue intensified. The death of one baby in the 1980s brought nationwide attention to the problem.
Who said "Do we really want to set the precedent of this great body, the United States Congress, to insert ourselves
“Do we really want to set the precedent of this great body, the United States Congress, to insert ourselves in the middle of families’ private matters all across America?” —Representative Debbie Wasserman Schultz, commenting on government intervention.
Who said "We must work diligently to not only help Terri Schiavo continue her own fight for life, but
“We must work diligently to not only help Terri Schiavo continue her own fight for life, but to join the fight of all those who have lost the capacity to fight on their own.” —Representative James Sensenbrenner, commenting on government intervention.
Was Terri Schiavo terminally ill?
“Make no mistake: Terri Schiavo was not terminally ill or near death. This case was not an end-of-life decision. This was a decision to end a life.” —David Gibbs, attorney for Terri Schiavo’s parents.
What is life sustaining treatment?
Life-sustaining treatment is defined as mechanical ventilation, renal dialysis, chemotherapy, antibiotics, and artificial nutrition and hydration.
What is the goal of withdrawing life sustaining treatment?
1. The goal of withdrawing life sustaining treatment is to remove treatments that are no longer desired or do not provide comfort to the patient. 2. The withholding of life-sustaining treatments is morally and legally equivalent to their withdrawal. 3.
How long does hemodialysis last?
Many chronic hemodialysis patients have survived for more than 10 years of therapy, some for more than 30 years.1,2 Despite this success in treating the uremic syndrome of end-stage renal disease (ESRD) patients by hemodialysis, knowledge of the toxins retained in the body after the loss of kidney function, so-called uremic toxins, and how much of those toxins to remove during hemodialysis therapy remains incomplete.
When is it appropriate to withhold or withdraw therapy?
It is appropriate clinically, ethically, and legally to withhold or withdraw therapies when the burden to the patient outweighs the benefit. Distress of patients and their families can be minimized by symptom palliation and by ongoing communication about the patient's condition, prognosis, and treatment alternatives.
Can life sustaining therapies be withheld?
Life-sustaining therapies are frequently withheld or withdrawn. Ethically and legally, the decision to withhold or withdraw therapies is guided by the principle of autonomy; patients or their surrogates have the right to refuse any therapy, even if it results in death.
What is life sustaining treatment?
Life-sustaining treatment is any treatment that serves to prolong life without reversing the underlying medical condition. Life-sustaining treatment may include, but is not limited to, mechanical ventilation, renal dialysis, chemotherapy, antibiotics, and artificial nutrition and hydration. There is no ethical distinction between withdrawing ...
What is the discouraging evidence of inadequate end-of-life decision making?
The discouraging evidence of inadequate end-of-life decision making indicates the necessity of several improvement strategies: (1) Patients and physicians should make use of advisory as well as statutory documents. Advisory documents aim to accurately represent a patient’s wishes and are legally binding under law.
What is the social commitment of a physician?
The social commitment of the physician is to sustain life and relieve suffering. Where the performance of one duty conflicts with the other, the preferences of the patient should prevail. The principle of patient autonomy requires that physicians respect the decision to forgo life-sustaining treatment of a patient who possesses decision-making ...
What is advisory document?
Advisory documents aim to accurately represent a patient’s wishes and are legally binding under law. Statutory documents give physicians immunity from malpractice for following a patient’s wishes. If a form is not available that combines the two, an advisory document should be appended to the state statutory form.
Is it unethical to discontinue all means of life-sustaining medical treatment?
Even if the patient is not terminally ill or permanently unconscious, it is not unethical to discontinue all means of life-sustaining medical treatment in accordance with a proper substituted judgment or best interests analysis.
Is there an ethical distinction between withdrawing and withholding life-sustaining treatment?
There is no ethical distinction between withdrawing and withholding life-sustaining treatment. A competent, adult patient may, in advance, formulate and provide a valid consent to the withholding or withdrawal of life-support systems in the event that injury or illness renders that individual incompetent to make such a decision.
What is passive euthanasia?
b. In passive euthanasia, the individual's death is the result of an assisted suicide, rather than a lethal injection on the part of another. c.
What is a living will?
With a living will, you can made advance decisions about whether or not you want extraordinary measures taken, and with a durable power of attorney others make those decisions for you. a. With a living will, a stranger may determine how to interpret your wishes if you are dying you cannot communicate them, and with a durable power ...
What is persistent vegetative state?
In persistent vegetative state, the individual has lost all brain function but still can breathe on their own. b. In persistent vegetative state, the individual has lost all brain stem function but has retained some good cerebral cortex function. c.
What is the difference between a living will and a durable power of attorney?
What is one difference between a living will and a durable power of attorney? a. With a living will, a stranger may determine how to interpret your wishes if you are dying you cannot communicate them, and with a durable power of attorney someone you appoint can make medical decisions for you when you are unable to. b.