A Costly Separation Between Withdrawing and Withholding Treatment in Intensive Care.
ABSTRACT Ethical analyses, professional guidelines and legal decisions support the equivalence thesis for life-sustaining treatment: if it is ethical to withhold treatment, it would be ethical to withdraw the same treatment. In this paper we explore reasons why the majority of medical professionals...
| Publicado en: | Bioethics Vol. 28; no. 3; pp. 127 - 138 |
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| Autores principales: | , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104031022&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104031022 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02699702 6PJ jtl: Bioethics issn: 02699702 maglogo: Y pubinfo: dt: Mar2014 vid: 28 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104031022 2012477980 10.1111/j.1467-8519.2012.01981.x NLM22762352 PMC3465577 104031022 ppf: 127 ppct: 11 formats: fmt: @attributes: type: P tig: atl: A Costly Separation Between Withdrawing and Withholding Treatment in Intensive Care. aug: au: Wilkinson, Dominic Savulescu, Julian affil: Women's and Children's Hospital, Adelaide sug: subj: Critical Care Ethical Issues Refusal to Treat Ethical Issues Health Resource Allocation Ethical Issues Critical Care Economics Refusal to Treat Economics Ethics, Medical Resource Allocation Ethical Issues ab: ABSTRACT Ethical analyses, professional guidelines and legal decisions support the equivalence thesis for life-sustaining treatment: if it is ethical to withhold treatment, it would be ethical to withdraw the same treatment. In this paper we explore reasons why the majority of medical professionals disagree with the conclusions of ethical analysis. Resource allocation is considered by clinicians to be a legitimate reason to withhold but not to withdraw intensive care treatment. We analyse five arguments in favour of non-equivalence, and find only relatively weak reasons to restrict rationing to withholding treatment. On the contrary, resource allocation provides a strong argument in favour of equivalence: non-equivalence causes preventable death in critically ill patients. We outline two proposals for increasing equivalence in practice: (1) reduction of the mortality threshold for treatment withdrawal, (2) time-limited trials of intensive care. These strategies would help to move practice towards more rational treatment limitation decisions. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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