Is withdrawal of life-sustaining treatment legal in the U.S.? It isn't in some countries. It IS, in the UK, where it is entirely the doctor's decision based on the patient's best interests or the understanding of it, though family are invariably explained things so that they're on the same page as the doctor.
Full Answer
What is withdrawal of Life-Sustaining Treatment?
Withdrawal of life sustaining treatment. Decisions to withdraw treatment are not uncommon in some clinical settings. In palliative care, they are the norm. They are commonly reached by mutual agreement between the patient and clinicians, and treatment focuses on managing the process of dying, rather than sustaining life.
How willing is the public to withdraw therapy?
The public appears much less willing than physicians to withhold therapy (40.2 versus 82.3 percent, respectively), although a strong majority (77.7 percent in one study) is willing to withdraw therapy [ 18 ]. Misgivings are not unique to US physicians.
What is the law on withdrawal of life support?
The issue of withholding and withdrawal of life support was first addressed by the U.S. Supreme Court in the Cruzan (8) case, which involved a parental request to have a feeding tube removed from their vegetative daughter. The Cruzans lived in Missouri, which required specific evidence that an incompetent patient would want treatment withdrawn.
Should life-sustaining therapy be withheld or withdrawn?
First, because the foregoing of life-sustaining therapy is only legally justified if such support represents unwanted treatment, it should be withheld or withdrawn only with the consent of patients or their surrogates, assuming surrogates are available.
Is withdrawal of life support 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.
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.
Is withholding medical treatment legal?
There is no legal basis for physicians who act sensitively and responsibly in the withholding or withdrawal of treatment to fear conviction under criminal law.
Can you refuse life saving treatment?
After a competent patient chooses to forego a life-sustaining treatment or procedure, the healthcare team is faced with only one option: We must support the wishes of the patient that will ultimately result in his or her death. Forcing treatment on a patient without his or her informed consent is illegal.
What happens if a patient refuses life saving treatment?
When patients in need explicitly refuse life-sustaining emergency treatment, the physician must choose between the undesirable options of forgoing beneficial treatment and forcing treatment on a competent but unwilling patient [1], both of which have potential ethical and legal consequences.
Can doctors turn off life support without family consent United States?
For instance, according to the American Thoracic Society,14 although doctors should consider both medical and patient values when making treatment recommendations, they may withhold or withdraw treatment without the consent of patients or surrogates if the patient's survival would not be meaningful in quality or ...
Is withholding medicine a crime?
Withholding therapy may cause a charge of manslaughter and the intended withdrawal of therapy may result in proceedings because of second-degree murder, requested homicide and omission of help, respectively.
Is withholding medication a crime?
Deliberate negligence This involves a caretaker or family member deliberately choosing not to provide medication to the elderly individual. Even if the first few times were accidental, refusing to correct the issue can lead to any potential criminal charges being upgraded from negligent to deliberate.
Which legally allows parents to withhold life sustaining treatment from a terminally ill child?
ADVANCE DIRECTIVES Those two legal documents are 1) a living will or 2) the durable power of attorney. A living will must be properly witnessed by a notary, and allows the patient to state, in writing, that they do not wish to be kept alive by artificial means or heroic measures.
Can you be forced to take medication?
In most cases, you cannot be forced to take medication. If you are offered medication, you usually have the right to refuse it and ask for an alternative treatment.
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.
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 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.
Did Nancy Ellen Jobes get her feeding tube removed?
Despite the various court rulings, the problems surrounding the removal of a feeding tube arose again in New Jersey when the parents of Nancy Ellen Jobes filed for the right to remove their daughter’s artificial nutrition. The issue was nearly identical to that of Cruzan. Authors Armstrong and Cohen explain: “Physicians and health care facility administrators were refusing to allow the withdrawal of life-supporting technology from a patient for whom the treatment offered no hope of improvement —to say nothing of recovery.” 109 Ultimately, the court ruled in Jobes’s favor, enabling the family to have the feeding tube removed.
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 the only legal rule on futile or nonbeneficial treatment?
In this regard, the only clear legal rule on futile or nonbeneficial treatment is the traditional malpractice test, which measures a physician's treatment decisions against the appropriate standard of medical care and then requires that any substandard care cause the patient injury.
What is the Supreme Court case about withholding life support?
Supreme Court in the Cruzan ( 8) case, which involved a parental request to have a feeding tube removed from their vegetative daughter.
What is palliative care?
Palliative care is the prevention or treatment of pain, dyspnea, and other kinds of suffering in terminally ill patients. These closely related practices are supported by the ethical principles of autonomy, beneficence, and nonmaleficence, as discussed in this ( 4) and other ( 5) publications. Physicians and other health professionals may be ...
Is life support withheld or withdrawn?
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. The principles hold that treatment may not be initiated without the approval of patients or their surrogates excepting in emergency ...
What was Terry Schiavo's case?
A notable case in the media was that of Terry Schiavo in 2005. 1 Her case dealt with whether her husband could decide to discontinue her artificial nutrition. It sparked a national debate. Although her case was very prominent in the news, it’s not the only case like it in the U.S.
What is life support?
Life-sustaining treatment, also known as life support, is any treatment intended to prolong life without curing or reversing the underlying medical condition. This can include mechanical ventilation, artificial nutrition or hydration, kidney dialysis, chemotherapy, and antibiotics. 2 .
Key Points
In most Western jurisdictions, withdrawing or withholding life-sustaining treatment (LST) at a competent patient’s request is considered morally equivalent and is supported ethically and legally.
Introduction
The intensive care unit (ICU) presents daily opportunities for ethical discussions, dilemmas, and resolutions. Issues run the gamut from competency and informed consent to surrogate decision making, futility, withdrawing and withholding of life sustaining treatments (LSTs), and vital organ donation.
Withholding or Withdrawing Life-Sustaining Treatments
Withholding a treatment refers to a decision to not start or escalate an intervention, and withdrawing a treatment refers to discontinuing therapy that has already begun.
Futility
Futility is often raised as a justification for withdrawing and withholding decisions. Treatment that is perceived to be futile is common in the ICU setting; in one study, approximately 20 percent of patients in the ICU were adjudged to have received futile (11 percent) or probably futile (8.6 percent) care [ 39 ].