David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Bioethics 28 (3):127-137 (2014)
Ethical analyses, professional guidelines and legal decisions support the equivalence thesis for life-sustaining treatment: if it is ethical to withhold treatment, it would be ethical to withdraw the same treatment. In this paper we explore reasons why the majority of medical professionals disagree with the conclusions of ethical analysis. Resource allocation is considered by clinicians to be a legitimate reason to withhold but not to withdraw intensive care treatment. We analyse five arguments in favour of non-equivalence, and find only relatively weak reasons to restrict rationing to withholding treatment. On the contrary, resource allocation provides a strong argument in favour of equivalence: non-equivalence causes preventable death in critically ill patients. We outline two proposals for increasing equivalence in practice: (1) reduction of the mortality threshold for treatment withdrawal, (2) time-limited trials of intensive care. These strategies would help to move practice towards more rational treatment limitation decisions
|Keywords||medical ethics health care rationing resource allocation withholding treatment intensive care|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
D. Wilkinson (2013). Which Newborn Infants Are Too Expensive to Treat? Camosy and Rationing in Intensive Care. Journal of Medical Ethics 39 (8):502-506.
D. Wilkinson (2013). Three Myths in End-of-Life Care. Journal of Medical Ethics 39 (6):389-390.
Similar books and articles
Kath M. Melia (2004). Health Care Ethics: Lessons From Intensive Care. Sage Publications.
Michael Gill, Picu Prometheus: Ethical Issues in the Treatment of Very Sick Children in Paediatric Intensive Care.
L. J. Schneiderman (1995). Wrong Medicine: Doctors, Patients, and Futile Treatment. Johns Hopkins University Press.
Nicolas Porta & Joel Frader (2007). Withholding Hydration and Nutrition in Newborns. Theoretical Medicine and Bioethics 28 (5):443-451.
David F. Kelly (2004). Contemporary Catholic Health Care Ethics. Georgetown University Press.
Jessica Price & Agnes Binagwaho (2010). From Medical Rationing to Rationalizing the Use of Human Resources for Aids Care and Treatment in Africa: A Case for Task Shifting. Developing World Bioethics 10 (2):99-103.
Sami Alsolamy (2014). Islamic Views on Artificial Nutrition and Hydration in Terminally Ill Patients. Bioethics 28 (2):96-99.
Peter Singer (1988). Age and the Allocation of Medical Resources. Journal of Medicine and Philosophy 13 (1):101-116.
Hanne Irene Jensen, Jette Ammentorp, Helle Johannessen & Helle Ørding (2013). Challenges in End-of-Life Decisions in the Intensive Care Unit: An Ethical Perspective. [REVIEW] Journal of Bioethical Inquiry 10 (1):93-101.
F. Cheng, Mary Ip, K. K. Wong & W. W. Yan (1998). Critical Care Ethics in Hong Kong: Cross-Cultural Conflicts as East Meets West. Journal of Medicine and Philosophy 23 (6):616 – 627.
Dominic Wilkinson (2009). The Self-Fulfilling Prophecy in Intensive Care. Theoretical Medicine and Bioethics 30 (6):401-410.
Robert A. Pearlman (1992). An Ethical Framework for Rationing Health Care. Journal of Medicine and Philosophy 17 (1):79-96.
M. Davie & A. Kaiser (2007). Semi-Qualitative Study of Staff Attitudes to Care Following Decision to Withdraw Active Treatment in a Neonatal Intensive Care Unit. Clinical Ethics 2 (3):133-138.
William H. Bruening (1992). Autonomy and Futility. HEC Forum 4 (5):305-313.
Added to index2012-07-06
Total downloads97 ( #34,937 of 1,777,408 )
Recent downloads (6 months)4 ( #142,865 of 1,777,408 )
How can I increase my downloads?