title: New guidelines on foregoing life-sustaining treatment in incompetent patients: an anti-cruelty policy.
abstract: When certain ailments are an overwhelming and irremediable encumbrance, treatment directed at other curable ailments, although life-saving, cannot effectively achieve the goals of medicine. We are morally constrained from perpetuating the effects of a hopeless injury without prospect of benefit to the patient. An anti-cruelty policy is proposed as a new guideline for foregoing life-sustaining treatment that transcends the doctrines of "substituted judgment" or "reasonable persons" for certain incompetent patients. We propose the use of "anti-cruelty care" as an active chart order or progress note, and suggest that institutional ethics committees or governing bodies recommend its implementation.
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications; D004644:Emotions; D026689:Ethical Analysis; D028741:Ethics Committees, Clinical; D004992:Ethics, Medical; D005065:Euthanasia; D005066:Euthanasia, Passive; D005190:Family; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000628:therapy; D008607:Intellectual Disability / Q000150:complications; D008020:Life Support Care / Q000592:standards*; D008297:Male; D001523:Mental Disorders; D010146:Pain; D010344:Patient Advocacy / Q000592:standards*; D018579:Patient Selection; D028723:Personhood; D018570:Risk Assessment; D013315:Stress, Psychological; D013736:Testicular Neoplasms / Q000150:complications / Q000628:therapy; D026712:Value of Life; D028761:Withholding Treatment