AI Article Synopsis
- ECMO is primarily seen as a temporary measure for patients either recovering or awaiting a transplant, but some patients insist on its continuation despite low chances of recovery and ineligibility for transplant.
- Critical care teams are seeking ethical guidance on whether it's acceptable to withdraw ECMO support against the wishes of patients who can make decisions.
- The article critiques existing ethical justifications for withdrawing ECMO support from capable patients, concluding that better arguments are needed or reconsidering the notion that ECMO shouldn't be used as long-term treatment.
Article Abstract
Extracorporeal membrane oxygenation (ECMO) is typically viewed as a time-limited intervention-a bridge to recovery or transplant-not a destination therapy. However, some patients with decision-making capacity request continued ECMO support despite a poor prognosis for recovery and lack of viability as a transplant candidate. In response, critical care teams have asked for guidance regarding the ethical permissibility of unilateral withdrawal over the objections of a capacitated patient. In this article, we evaluate several ethical arguments that have been made in favor of withdrawal, including distributive justice, quality of life, patients' rights, professional integrity, and the Equivalence Thesis. We find that existing justifications for unilateral withdrawal of ECMO support in capacitated patients are problematic, which leads us to conclude that either: (1) additional ethical arguments are necessary to defend this approach or (2) the claim that it is not appropriate to use ECMO as a destination therapy should be questioned.
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| http://dx.doi.org/10.1080/15265161.2022.2075959 | DOI Listing |
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