Initiating and Withdrawing Life Support: Principles and Practice in Adult Medicine
Ruark, John Edward
Raffin, Thomas Alfred
New England Journal of Medicine. 1988 Jan 7; 318(1): 25-30.
Issues in initiating and withdrawing life support are discussed in an article co-authored by the Stanford University Medical Center Committee on Ethics and two of its physician members. Recent court decisions involving life support and legislation on living wills are cited. General and specific principles are suggested for appropriate decision making: establishment of authority, communication with patients and their families, determination and review of quality of life values, and recognition of patients' rights. These principles are applied to four situations: initiating basic life support (food, water, and oxygen), initiating advanced life support, withdrawing advanced life support, and withdrawing basic life support. While this article is not intended to represent the official policy of Stanford University or Stanford University Medical Center, its principles were voted unanimous support by members of the Committee on Ethics. (KIE abstract)
Adults; Allowing to Die; Artificial Feeding; Autonomy; Clinical Ethics; Clinical Ethics Committees; Communication; Competence; Consent; Decision Making; Disclosure; Ethics; Ethics Committees; Extraordinary Treatment; Family Members; Food; Hospitals; Institutional Policies; Legal Aspects; Legislation; Life; Living Wills; Medicine; Patients; Patients' Rights; Persistent Vegetative State; Physicians; Prognosis; Prolongation of Life; Quality of Life; Resuscitation; Resuscitation Orders; Review; Rights; Selection for Treatment; Standards; Terminally Ill; Third Party Consent; Values; Withholding Treatment; Wills;