Life, Death, and Heartache: Ethical Dilemmas Get Tougher


November 15, 2012

In This Article

Fight a Family That Wants to End Treatment?

Would you ever go against a family's wishes to end treatment, in order to continue treating a patient whom you felt had a chance to recover?

Typically, a family wants to keep their loved one alive no matter what, but there are instances when the family wants to terminate treatment when a physician thinks it's premature to do so.

A small number of the responses were downright chilling. Almost one quarter (23%) of respondents said they'd fight the family; 32% said they would not, and 45% said it depends.

"I did that once, with a young healthy female who overdosed and was on a ventilator. Her 18-year-old son wanted to terminate treatment,' said one physician, who noted that he fought the son's decision and continued treatment. "My primary responsibility is still to my patient," said another.

"I don't believe in euthanasia, so if I felt a patient had a reasonable chance to recover, I would get an ethics committee opinion or ask the family to find another physician if they wish to terminate care," said one doctor.

"Sometimes family members realize that the patient will be disabled and require lifelong medical care, and so they want to terminate treatment; yet, the termination is mostly for the family's own convenience," said Dr. Prager.

Many physicians said they had discussions with the family as to why treatment should continue. But others said the decision belongs to the family, even if the physician disagrees. "If the family is the authorized legal guardian and it is their decision and the patient cannot express a preference, it is not my place to go against them," said one respondent.

Sometimes family members believe that a medically challenged or disabled patient will have such a terrible quality of life, that he or she would not want to live. However, even patients in terrible condition often have a strong fight to hang on. "Very often, the person with the disability still wants to live," said Dr. Prager.