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Medicine and Public Policy |

New Guidelines on Foregoing Life-Sustaining Treatment in Incompetent Patients: An Anti-Cruelty Policy

SUSAN BRAITHWAITE, M.D.; and DAVID C. THOMASMA, Ph.D.
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▸Requests for reprints should be addressed to Susan Braithwaite, M.D.; Loyola University Stritch School of Medicine, 2160 South First Avenue; Maywood, IL 60153.


Maywood, Illinois


© 1986 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1986;104(5):711-715. doi:10.7326/0003-4819-104-5-711
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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.

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