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Introduction: Patients in intensive care units (ICUs) have treatment limited or withdrawn if further treatment is considered futile. This multicentre prospective observational study was part of a European study of patterns of limitations.
Methods: In the first six months of 2016, all patients admitted to three Danish ICUs were screened and those with treatment limitations or death in the ICU were included.
Ethics Consultations at a Major Academic Medical Center: A Retrospective, Longitudinal Analysis.
AJOB Empir Bioeth
July 2021
Brigham and Women's Hospital, Boston, Massachusetts, USA.
Background: Evidence suggests that healthcare professionals feel inadequately equipped to manage ethical issues that arise, resulting in ethics-related stress. Clinical ethics consultation, and preventive ethics strategies, have been described as ways to decrease ethics-related stress, however information is limited regarding specific sources of ethical concern.
Methods: The purpose of this study was to conduct a retrospective, longitudinal analysis of a comprehensive database of ethics consultations, at a major academic medical center in the Northeast United States in order to: (1) Discern major sources of ethical concern, (2) Evaluate how these have changed over time in their content and frequency, (2a) Evaluate trends in nurse versus physician-initiated requests.
Rethinking the withholding/withdrawing distinction: the cultural construction of "life-support" and the framing of end-of-life decisions.
Multidiscip Respir Med
May 2015
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
This paper is a theoretical and empirically informed examination of the naturalist distinction between withholding and withdrawing life-support. Drawing on the history of mechanical ventilation and on a recent Israeli law containing a novel approach to disconnecting life-support at the end of life, it is argued that the design of machines predicates the division line between "active" and "passive" interventions, and that the distinction itself might be morally self-defeating. Informed by insights from moral psychology, behavioral economics and philosophies of technology, the paper warns against the placement of this old distinction at the heart of the moral and legal regulation of life-support at the end of life.
View Article and Find Full Text PDFThe withholding/withdrawing distinction in the end-of-life debate.
Multidiscip Respir Med
March 2014
Dipartimento di Scienze della Salute, University of Milan, Milan, Italy.
Toward the clarification of ideas: medical futility, persistent/obstinate therapy and extra/ordinary means.
Adv Exp Med Biol
November 2012
Department of Philosophy and Human Sciences, Silesian Medical University, Katowice, Poland.
Despite reluctance of a part of medical society to accept the moral and/or legal permission to euthanasia, there is seemingly a common agreement on the need to resolve the problem of excessive therapy. Several ethical concepts are used to justify decisions to withhold/withdraw such treatment. Three of them are of particular value.
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