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WITHHOLDING AND WITHDRAWING LIFE PROLONGING MEDICAL TREATMENT
Joyce Jarosik
Strategies
Grand Island Central Community College
June14, 2004
Withholding and Withdrawing Life Prolonging Medical Treatment
Introduction:
Principle of patient autonomy
A. ... Ethnical distinction of life-sustaining treatment
Valid Consent
Who decides
Jessica Meade’s mother decision
A. ... American Medical Association’s eight-step protocol
B. ... What medical societies can do
Conclusion
Withholding and Withdrawing Life Sustaining Medical Treatment
The social commitment of the health care provider is to sustain life and relieve suffering. ... The principle of patient autonomy requires that health care providers respect the decision to forego life-sustaining treatment of a patient who possesses decision-making capacity. So why is there such a controversy in who decides to forgo life-sustaining treatment? There is no ethnical distinction between withholding or withdrawing life-sustaining treatment. ... If treatment fails, who should decide? ... When Jessica Meade was born, doctors told her mom that she was so brain damaged she should be left in a nursing home where she would live in a vegetative state her entire life and was even asked to sign a form to withdraw life support. ... The American Medical Association established an eight-step protocol:
Be familiar with institutional policies and state laws. ...
Establish context for the discussion
Discuss specific treatment preferences. ...
In some cases, the patient is clearly unable to voice a wish to have treatment withheld. ...
Health care providers should provide relevant medical information and explain treatment based on substituted judgment (what the patient would have decided) when there is no evidence of patients preferences and values. In making that decision, the decision-maker may consider the patient’s values about life and the way it should be lived, their attitude toward sickness, suffering, medical procedures, and death---or the best interest of the patient (what outcome would most likely promote the patient’s well-being. ...
With the interpretations clearly stated, why does the medical profession still question the intent of the patient or the representation of the family making the request? ... In their minds, the treatment was not futile--treatment was beneficial. ... However, he was not hooked to any life sustaining treatment. Why, was it because he was 78 and lived a nice life? There were no advanced directives but the family requested no life support and their request were honored. ... Although not all the facts were revealed about the 78-year-old, one would still wonder if age might have been the determining factor in this case because it was truly clear that neither wanted life support. ... Even when 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 interest analysis according to Principles I, III, IV, and V of the American College of Physicians’ Ethics Manual.
Approximate Word count = 2197
Approximate Pages = 8.8
(250 words per page double spaced)
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