Withdrawing Intensive Life-Sustaining Treatment — Recommendations for Compassionate Clinical Management

TLDR

Although patients and surrogates have a legal right to refuse life‑prolonging therapy, many dying patients in U.S. hospitals still receive unwanted interventions, and there is a lack of clinicians trained to manage the transition from aggressive to palliative care. The study identifies a lack of training among physicians and nurses in withdrawing intensive life support as a key reason for unwanted interventions.

Abstract

Despite an ethical and legal consensus regarding the right of patients or their surrogates to refuse life-prolonging therapy, surveys show that dying patients in hospitals in the United States frequently receive unwanted interventions.1,2 One reason for this may be a lack of training among physicians and nurses in the clinical aspects of withdrawing intensive life support. Staff members are highly skilled in aggressive life-extending treatment, and some hospitals now have services specializing in palliative care for patients forgoing life-extending treatment. But there may be no one specifically trained in managing the transition from one style of care to the . . .