Withdrawing may be preferable to withholding.
The majority of deaths on the intensive care unit now occur following a decision to limit life-sustaining therapy, and end-of-life decision making is an accepted and important part of modern intensive care medical practice. 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. Despite wide agreement by Western ethicists that there is no ethical difference between these two approaches, these issues continue to generate considerable debate. In this article, I will provide arguments why, although the two actions are indeed ethically equivalent, withdrawing life-sustaining therapy may in fact be preferable to withholding.
Department of Intensive Care, Erasme Hospital, Free University of Brussels, Belgium. jlvincen@ulb.ac.be
Jean-Louis
JL
Vincent
D001291:Attitude of Health Personnel; D003657:Decision Making; D006801:Humans; D007362:Intensive Care Units; D018447:Medical Futility; D011788:Quality of Life / Q000523:psychology; D016414:Resuscitation Orders; D028761:Withholding Treatment / Q000941:ethics*