Ethical considerations relating to terminal weaning in intensive care

The ethical considerations relating to terminal weaning from mechanical ventilation will be discussed within this paper. The principles of beneficence, non-maleficence and autonomy are seen to be the key considerations within the discussion. The difference between terminal weaning and regular weaning from a ventilator is that it proceeds as vital signs deteriorate and the expected outcome is death of the patient. A deterioration in vital signs would normally result in a change in the weaning process. The indications for terminal weaning have been classified into three categories by Campbell and Carlson. These are the patient's informed request to have the ventilator withdrawn, reduction of patient pain and suffering and medical futility. These categories will be used to facilitate the discussion which will draw on both the relevant literature and clinical experience.