Patient Request for Treatment Withdrawal or Terminal Wean

Patient Request for Treatment Withdrawal or Terminal Wean 

When considering commencement or continuation of mechanical ventilation, the potential benefits, risks, and burdens of this support should be considered, taking into account the patient s wishes (respect for autonomy). The patient already receiving chronic ventilation. 

Much debate has occurred as to whether passive euthanasia is euthanasia at aU. Garrad and Wilkinson (10) note that although active euthanasia is ethieaUy unaceeptable, omission of prolonging treatments is somehow justified morally. The law seems to support this view in some ways. 

A relevant example is of Miss B (11), a woman who was deemed to be eompetent, was receiving long-term invasive mechanical ventilation, and requested the clinical staff to remove her from the ventilator. Although the staff refused, the courts decided that to continue mechanical ventilation against her wishes was unlawful and that she was competent to refuse this treatment, even if it led to her death. There was legal acceptance that it was permissible to allow her to end her life and that to continue with a treatment against her wishes was an assault. This has been described as legally sanctioned ethical homicide, assisted suicide, and active euthanasia. 

Understanding the primary intention and gaining consent for withholding or withdrawing care in the competent patient is a vital step. We need to be certain that tlie patient is 

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V. Patient Request for Treatment Withdrawal or Terminal Wean... 

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