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Stopping Life Supporting Treatment without Patient/Surrogate Consent

Posted Feb 27 2011 12:25pm
Los Angeles physician Maurice Bernstein, who runs the Bioethics Discussion Blog , currently is hosting a discussion focused on the following question:  Under what conditions, if any, should a physician deny further attempt to keep a patient alive but continuing comfort care in defiance of the known request of the patient or the family to continue life supportive treatments?  Here is his further explanation of the discussion focus:

Modern medical science has provided physicians the ability and tools to continue life despite inability to cure the patient of the illness yet maintaining the patient’s life even if the life is one of being permanently unaware or, to an average patient, a life of no further personal value.

It is not unusual these days that physicians are challenged by the patient or the patient’s families to continue the life supportive treatments until death regardless of the negative consequences to the patient and others.

Should physicians be permitted to reject such requests? Currently, physicians can reject requests for treatment which has not been found to have any scientific basis for its use and which its use is not in keeping with professional standards.  Such a treatment is characterized as “physiologically futile.”  But what if the treatment has a scientific basis for use and if used can keep the patient alive but the treatment doesn’t cure?  This form of treatment cannot be considered futile (of no value) if on continuing such a treatment the patient accepts the consequences of maintaining their life with this treatment but without cure.  Nevertheless, does the patient's or family's desires trump any advice of the physician to terminate life support?  Any answers? 
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