Deciding to terminate treatment: a practical guide for physicians

Area of Science:

• Medical Ethics
• Legal Medicine
• Clinical Decision-Making

Background:

• Physicians require clear guidance for complex end-of-life treatment termination decisions.
• Existing literature and legal frameworks offer a basis for developing practical guidelines.

Purpose of the Study:

• To provide house officers and practicing physicians with annotated, concise, practical guidelines for decisions to terminate treatment.
• To develop a systematic approach to end-of-life decision-making.

Main Methods:

• Focused study selection and data extraction on statutes, regulations, court decisions, medicolegal analyses, clinical studies, and position papers.
• Developed a laminated, pocket-sized card with a series of questions for physicians.

Main Results:

• A systematic checklist was created to guide physicians through critical assessment points.
• The checklist addresses brain death, impairment assessment, treatment type, futility, patient capacity, patient wishes, surrogate roles, and legal/ethical considerations.

Conclusions:

• Systematic assessment of key factors enhances efficiency and value in end-of-life decision-making.
• The developed guidelines and checklist support physicians in navigating termination-of-treatment issues ethically and legally.