When facing decisions about withholding or withdrawing life- sustaining treatment the physician should: Review with the patient the individual’s advance directive, if there is one. Otherwise, elicit the patient’s values, goals for care, and treatment preferences.
When facing decisions about withholding or withdrawing life-sustaining treatment the physician?
When facing decisions about withholding or withdrawing life- sustaining treatment the physician should: Review with the patient the individual’s advance directive, if there is one. Otherwise, elicit the patient’s values, goals for care, and treatment preferences.
What is the difference between withholding and withdrawing treatment?
While withholding treatment and withdrawing treatment refer to actions taken by health care providers, the actual decision to decline or discontinue treatment rests with the patient or the patient’s family or substitute decision-maker.
Will controversy continue to centre on withholding and withdrawing medical treatment?
This makes it very much likely that controversy will continue to centre on the practice of withholding and withdrawing medical treatment, with particular reference to life-sustaining treatments [1].
Is withholding or withdrawing therapy ethical?
Withholding or withdrawing life-sustaining therapies is ethical and medically appropriate in some circumstances. This article summarizes the American Medical Association's Education for Physicians on End-of-life Care (EPEC) curriculum module on withholding or withdrawing therapy.
Who makes decisions regarding withholding or withdrawing treatment?
The patient or decision maker, after being provided appropriate counseling and options, decides against this intervention to reflect personal values. Information from Education for Physicians on End-of-Life Care Trainer's Guide, Module 11, withholding, withdrawing therapy.
How is withholding treatment different from withdrawing treatment?
“Withdrawing” was defined as the decision to stop a treatment already undertaken. “Withholding” was defined as the decision not to start or increase a treatment beyond a critical threshold.
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.
Who decides in withdrawal of treatment in a critical care setting a case study on ethical dilemma?
The Health Information and Quality Authority reported that autonomy is a general principle of medical practice, in which patients have the right to refuse or accept treatment [13]. A patient with this capability can decide whether to withhold or withdraw life-sustaining treatment [14].
What does withdrawal of treatment mean?
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.
What is meant by a patient refusing or withdrawing treatment?
A decision to withhold or withdraw life- sustaining treatment is a common feature of medical practice when caring for people who are approaching the end of life. 2. A person who has capacity can lawfully refuse treatment even if that treatment is needed to keep them alive. Such a refusal should be followed.
What is withholding life sustaining treatment?
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.
What is the definition of withholding life support?
Abstract. The withholding and withdrawal of life support are processes by which various medical interventions either are not given to or are taken away from patients, with the expectation that they will die as a result.
Can a doctor withhold treatment?
Can a physician refuse to treat a current patient? Yes, but the physician needs to follow appropriate guidelines. See California Medical Association (CMA) guidelines in regard to terminating the doctor/patient relationship.
Is withdrawal of treatment ethical?
The withdrawal of treatment is one of the most emotionally challenging and ethically complex aspects of end-of-life care. As our ability to prolong life progresses, the necessity to address issues such as the withdrawal of treatment increases in parallel.
Is there an ethical or legal difference between withholding and withdrawing medically assisted nutrition and hydration?
Although individuals may hold personal or professional reservations, withholding or withdrawing ANH is both legally and ethically permissible.
Is withdrawal or withholding of treatment equivalent to euthanasia?
It should be made clear that withholding or withdrawing life-sustaining therapies that are disproportionate to the expected outcome is not equivalent to euthanasia; it is in fact considered ethical and medically appropriate, as long as basic humane, compassionate care is not interrupted.
What does it mean when a patient decides not to use life-sustaining treatment?
A patient who decides not to use life-sustaining treatment or who decides not to continue using a life-sustaining treatment is not “committing suicide.”. Likewise, an agent who makes the same request on behalf of the patient is not “killing” the patient.
Why do people stay alive?
The person stays alive only because a machine or other treatment is doing the work that the body no longer can do. Many people want no part of a life sustained only by medical technology. Some feel that the burdens of being attached to a machine outweigh the benefits.
Can you be forced to stop using life sustaining measures?
No one can be forced to start using or keep using a life-sustaining measure they do not want. When a person may, or has, become dependent on such a treatment, decisions may need to be made about whether to withhold or withdraw the treatment (not start it, or stop using it).
When should a physician elicit patient goals of care?
Physicians should elicit patient goals of care and preferences regarding life-sustaining interventions early in the course of care, including the patient’s surrogate in that discussion whenever possible.
Is there an ethical difference between withholding and withdrawing treatment?
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.
Can a surrogate make decisions on behalf of a patient?
There is no surrogate available and willing to make decisions on behalf of a patient who does not have decision-making capacity or no surrogate can be identified. In the physician’s best professional judgment ...
Is it ethical to withhold life sustaining interventions?
Decisions to withhold or withdraw life-sustaining interventions can be ethically and emotionally challenging to all involved. However, a patient who has decision-making capacity appropriate to the decision at hand has the right to decline any medical intervention or ask that an intervention be stopped, even when that decision is expected to lead ...
Withholding treatment and withdrawing treatment
Traditionally, medicine has been focused on extending life. However as death approaches, extending life may not be in the best interests of the patient.
What About Food And Fluids?
Towards the end of a progressive, life-limiting illness, people reach a point where they can no longer eat or drink. They may be too weak and unable to swallow, or always sleeping. When people become too weak to swallow, they may cough or choke on what they are trying to eat or drink.
Palliative sedation
Palliative sedation involves giving medications to make a patient less aware, providing comfort that cannot be achieved otherwise. A legal and ethical practice in Canada, its goal is not to cause or hasten death but to keep the person comfortable until death.
Clinical Decisions
Giving Treatment
- A medical treatment can have two basic functions. First it can aim to cure the person. This is the sort of treatment that we hope to receive when we visit our GP. Our desire is to go in, describe the problem, have a few tests and come away with the treatment that solves it. To an extent, curing is about warding off death, because if illness is not stopped then a person may die. You could say …
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…