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On Being a Doctor |

Disconnecting a Ventilator at the Request of a Patient Who Knows He Will Then Die: The Doctor's Anguish

Miles J. Edwards, MD; and Susan W. Tolle, MD
[+] Article, Author, and Disclosure Information

The name of our patient was changed to protect patient confidentiality, and the family granted permission to share his story.

Requests for Reprints: Susan W. Tolle, MD, Director, Center for Ethics in Health Care, Oregon Health Sciences University L101, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098.

Current Author Addresses: Drs. Edwards and Tolle: Center for Ethics in Health Care, Oregon Health Sciences University L101, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098.

© 1992 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1992;117(3):254-256. doi:10.7326/0003-4819-117-3-254
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This excerpt has been provided in the absence of an abstract.

Recently we assisted in withdrawing life support from a patient who had repeatedly asked to have his ventilator disconnected, even after being informed that he would then die. We found little in the medical literature to guide us, especially at the feeling level, so we are sharing our experience with the hope that others will find our emotional responses, reasoning, and procedures useful.

The Case: Mr. Larson was a 67-year-old, obese white man. At 23 years of age he developed poliomyelitis and "spent six weeks in an iron lung." His neurologic recovery was virtually complete, and he resumed a reasonably






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