Deciding To Forego Life Sustaining Treatment

Abstract: A comprehensive report by the US President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research addresses some of the most important and troubling ethical and legal questions in modern medicine for consideration by health care professionals, lawyers, and relatives of patients regarding the sensitive topic of voluntary cessation of life-sustaining therapy for the seriously ill. It was concluded that the cases that involve true ethical difficulties are much fewer than commonly believed and that the perception of difficulties primarily occurs because of misunderstandings about the dictates of law and ethics. It also is concluded that, while competent informed patients have the authority to decline or accept health care, others must act on the behalf of incompetent patients. The report urges that health care institutions develop and use internal review methods that permit exploration of all relevant issues. The 7 report chapters are grouped around 2 themes: the various aspects of making treatment decisions; and patient groups raising special concerns (e.g.: permanently-unconscious patients; seriously-ill newborns. (wz).