End of life

Authored by: Chris Gastmans , Herman Nys

Routledge Handbook of Medical Law and Ethics

Print publication date:  August  2014
Online publication date:  September  2014

Print ISBN: 9780415628181
eBook ISBN: 9780203796184
Adobe ISBN: 9781134448654


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Treatment decisions at the end of life are common in contemporary clinical practice. According to Broeckaert and the Flemish Palliative Care Federation (2009), treatment decisions at the end of life, in principle, can be grouped into three categories. The first group encompasses decisions whether to initiate or withhold, continue or withdraw curative or life-sustaining treatments (e.g. cardiopulmonary resuscitation, artificial ventilation, dialysis, artificial nutrition and hydration). In this group, non-treatment decisions refer to ‘withdrawing or withholding a curative or life-sustaining treatment, because in the given situation this treatment is deemed to be no longer meaningful or effective’ (Broeckaert and the Flemish Palliative Care Federation 2009: 30–2). According to the British Medical Association (2007), treatment is usually unable to produce the desired benefit either because it cannot achieve its physiological aim or because the burdens of the treatment are considered to outweigh the benefits for the particular individual. This is called ‘futile’ treatment. Refusal of treatment occurs when the patient requests curative or life-sustaining treatment to be withdrawn or withheld.

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