ORA Journal article: "A costly separation between withdrawing and withholding treatment in intensive care." - uuid:3d749f04-3d0e-4d2f-9840-ae9b5c94713d


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Reference: Wilkinson, D and Savulescu, J, (2014). A costly separation between withdrawing and withholding treatment in intensive care. Bioethics, 28 (3), 127-137.

Citable link to this page: http://ora.ox.ac.uk/objects/uuid:3d749f04-3d0e-4d2f-9840-ae9b5c94713d
Title: A costly separation between withdrawing and withholding treatment in intensive care.

Abstract: Ethical analyses, professional guidelines and legal decisions support the equivalence thesis for life-sustaining treatment: if it is ethical to withhold treatment, it would be ethical to withdraw the same treatment. In this paper we explore reasons why the majority of medical professionals disagree with the conclusions of ethical analysis. Resource allocation is considered by clinicians to be a legitimate reason to withhold but not to withdraw intensive care treatment. We analyse five arguments in favour of non-equivalence, and find only relatively weak reasons to restrict rationing to withholding treatment. On the contrary, resource allocation provides a strong argument in favour of equivalence: non-equivalence causes preventable death in critically ill patients. We outline two proposals for increasing equivalence in practice: (1) reduction of the mortality threshold for treatment withdrawal, (2) time-limited trials of intensive care. These strategies would help to move practice towards more rational treatment limitation decisions.

Publication status:Published
About The Authors
Wilkinson, D More by this author
institutionUniversity of Oxford
Oxford, HUM, Philosophy, Philosophy Postholders
Bibliographic Details
Journal: Bioethics see more from them
Volume: 28
Issue: 3
Extent: 127-137
Issue Date: 2014-3
Urn: uuid:3d749f04-3d0e-4d2f-9840-ae9b5c94713d
Source identifier: 341113
Eissn: 1467-8519
Doi: 10.1111/j.1467-8519.2012.01981.x
Issn: 0269-9702
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