Withholding or Withdrawing Treatment

Fidel Davila, MD
JAMA. 1986;256(4):470-471. doi:10.1001/jama.1986.03380040043014.
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To the Editor.—  Recently, the American Medical Association (AMA) Council of Ethical and Judicial Affairs adopted a stand based on ethical considerations that allows the withholding of nutrition and fluids from patients under special clinical circumstances. This stand is a grievous error, since it impinges on legal areas reserved for judicial authorities and such withholding may be considered euthanasia, which is still illegal in this country.Most clinical decisions are directed at preserving life and have medical, ethical, and legal implications. When non-terminally ill patients or their stead refuse indicated life-preserving medical care including nutrition and fluids (eg, Brophy and Jobes), with the results of these refusals being certain death in the immediate future, the judicial authorities have reserved the right of final decision.1-4 These judicial authorities should be consulted on an urgent basis.In terminally ill patients for whom no life-preserving medical care is available, ethical considerations allow


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