This paper explores the ethical and legal issues of withdrawing life supports from prolonged mechanical ventilation-dependent patients. Common controversial ethical conceptions are analyzed. Certain American, Canadian and British Professional ethical guidelines concerning end-of-life care ethics are introduced and some classical cases are discussed. The authors then propose basic ethical principles of patient management based on whether patients have decision capacity and whether they are in terminal disease status. Finally the procedures and guidelines for ventilator withdrawal are presented. It is argued that using excessive and futile life supports to prolong the dying processes of patients are not of medical indication, and therefore physicians should avoid and terminate such practices based on professional judgment. The resolution of end-of-life care ethical dilemmas should base on the principles of respecting patient autonomy and promoting the best interest of the patients.
Date:
2012-03-25
Relation:
Formosan Journal of Medicine. 2012 Mar 25;16(2):56-73.
