When Life-Sustaining Treatment Is Withdrawn and the Patient Doesn’t Die

When Life-Sustaining Treatment Is Withdrawn and the Patient Doesn’t Die

Kutzsche S; Partridge JC; Leuthner SR; Lantos JD

Pediatrics

2013

Palliative Care; Palliative Care; Ethics; prognostication; withdrawal of life-sustaining treatment

One of the most difficult decisions that doctors and parents must make is the decision to withdraw life-sustaining treatment. Doctors find it easier to withdraw treatments in situations where withdrawal will be rapidly fatal rather than in situations in which treatment withdrawal will lead to a prolonged dying process. Mechanical ventilation is usually such a treatment. Withdrawal of ventilation generally leads to the patient’s rapid demise. Doctors may tell parents that death will occur quickly after a ventilator is withdrawn. But what happens when the doctors are wrong and a patient survives without life support? What should doctors do next? We present a case in which that happened and asked 3 experts to comment on the case. Stefan Kutzsche is a senior consultant in neonatology at Oslo University Hospital Ulleval in Norway. John Colin Partridge is a neonatologist and professor of pediatrics at University of California, San Francisco. Steven R. Leuthner is a neonatologist and professor of pediatrics and bioethics at the Medical College of Wisconsin. They each recommend slightly different approaches to this dilemma.

2013-10

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