Article Text
Statistics from Altmetric.com
Making decisions about withdrawing life-sustaining treatment is something that a neurologist will most frequently be involved with in the intensive care unit setting, in people who have suffered a catastrophic brain injury. The ethical position is relatively clear when there is no prospect of meaningful recovery and, inevitably, the patient lacks awareness. Such decisions are made on the basis of futility and on a best-interest basis. The decision will be made in consultation with any appointed attorney for such decisions or following discussion with family members about any wishes the patient may have expressed and recorded, including any advance statements.
However, when patients themselves request the withdrawal (or refuse the continuation) of life-sustaining treatment, this raises significant challenges for doctors and others and is the subject of the General Medical Council (UK) and other guidance. In UK law, a patient with capacity for that decision has the right to refuse any medical intervention or treatment. This request by the patient may be made either directly or through an advance decision to refuse treatment, …
Footnotes
Contributors All authors contributed to all aspects of the article.
Competing interests CJM was a coauthor on the APM guidelines and receives funding from the Motor Neurone Disease (MND) Association. CF led the work on the APM guidelines and receives funding from the MND Association.
Provenance and peer review Commissioned; internally peer reviewed.
Linked Articles
Read the full text or download the PDF:
Other content recommended for you
- Assisted ventilation in motor neurone disease during inpatient palliative care: barriers and utilisation
- Tracheostomy in motor neurone disease
- Withdrawal of invasive ventilation in a patient with motor neurone disease and total locked-in syndrome
- Mechanical ventilation withdrawal in motor neuron disease: an evaluation of practice
- Issues for palliative medicine doctors surrounding the withdrawal of non-invasive ventilation at the request of a patient with motor neurone disease: a scoping study
- The management of motor neurone disease
- P-183 Withdrawal of mechanical ventilation in motor neurone disease: an updated evaluation of practice
- Withdrawal of ventilation at the patient's request in MND: a retrospective exploration of the ethical and legal issues that have arisen for doctors in the UK
- Respiratory management of motor neurone disease: a review of current practice and new developments
- Weaning from prolonged invasive ventilation in motor neuron disease: analysis of outcomes and survival