Withdrawal of Life Support in the Terminally Ill
Withdrawal of Treatment
in Terminally Ill Patients
ABSTRACT: Withdrawal of certain life sustaining medical treatments such as cardiopulmonary resuscitation, artificial ventilation, nutrition/hydration, and antibiotics from terminally ill patients is an ethical issue which concerns patients, families, and healthcare providers. Ethical considerations surrounding end of life care poses a unique challenge and experience for all care providers. Other considerations of terminally ill patients of equal importance include spiritual and psychosocial care and maintaining quality of life until a painless death. However, as the media often focuses on controversy, ethical, social and legal issues will continue to surround the withdrawal of treatment in terminally ill patients.
Withdrawal of Treatment in Terminally Ill Patients
Withdrawal of certain life sustaining medical treatments such as cardiopulmonary resuscitation, artificial ventilation, nutrition/hydration, and antibiotics from terminally ill patients is an ethical issue which concerns patients, families, and healthcare providers. Such withdrawal of treatment is often referred to as “Passive Euthanasia.” Ethical considerations surrounding end of life care poses a unique challenge and experience for all care providers (Tong, 2007).
During the course of a terminal illness, a meeting between health care professionals and the patient/family is necessary to review the disease course and develop end-of-life goals of care. End-of-life family conferences are aimed at improving communication with relatives of dying patients and at easing the burden that weighs on the family. Family conferences are held when a shift is needed from curative to palliative care. End of life and palliative address the psychological and social needs of the patients, focusing on pain/symptom management and quality of life. For nursing professionals providing palliative care, end of life care can be a unique challenge and experience (Verpoort et al., 2004).
Some of these challenges of palliative/end of life care include ethical issues surrounding withdrawal of treatment versus quality of life including psychological, physical, social and spiritual needs (Harvath, 2004). Ethical, social and cultural factors play a significant role in decisions of withdrawing or withholding treatment.
Nurses’ attitudes surrounding euthanasia and end-of life ethical issues were studied by Verpoort et al (2004). Reportedly, age, religion and nursing specialty influence opinions on end of life care or termination of treatment.
The case of Terri Schiavo successfully highlighted the ethical, legal and social issues of withdrawing and withholding treatment. Many question whether Terri Schiavo’s parents acted selfishly by keeping their daughter alive,