SUSAN BRAITHWAITE, M.D.; DAVID C. THOMASMA, Ph.D.
When certain ailments are an overwhelming and irremediable encumbrance, treatment directed at other curable ailments, although life-saving, cannot effectively achieve the goals of medicine. We are morally constrained from perpetuating the effects of a hopeless injury without prospect of benefit to the patient. An anti-cruelty policy is proposed as a new guideline for foregoing life-sustaining treatment that transcends the doctrines of "substituted judgment" or "reasonable persons" for certain incompetent patients. We propose the use of "anti-cruelty care" as an active chart order or progress note, and suggest that institutional ethics committees or governing bodies recommend its implementation.
BRAITHWAITE S, THOMASMA DC. New Guidelines on Foregoing Life-Sustaining Treatment in Incompetent Patients: An Anti-Cruelty Policy. Ann Intern Med. ;104:711–715. doi: 10.7326/0003-4819-104-5-711
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Published: Ann Intern Med. 1986;104(5):711-715.
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