Debate: What constitutes 'terminality' and how does it relate to a Living Will?

doi:10.1186/cc717

Critical Care
Volume 4
Issue 6

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Crippen D
Levy M
Truog R
Whetstine L
Luce J

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Levy M
Truog R
Whetstine L
Luce J
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Commentary

Debate: What constitutes 'terminality' and how does it relate to a Living Will?

David Crippen¹, Mitchell Levy², Robert Truog³, Leslie Whetstine⁴ and John Luce⁵

¹University of Pittsburgh Medical Center, and Department of Emergency and Critical Care Medicine, St Francis Medical Center, Pittsburgh, Pennsylvania, USA

²Department of Critical Care, Rhode Island Hospital, Providence, Rhode Island, USA

³Multidisciplinary Intensive Care Unit, Children's Hospital, Farley, Boston, Massachusetts, USA

⁴Medical Ethics, Duquesne University, Pittsburgh, Pennsylvania, USA

⁵Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, San Francisco, USA

Critical Care 2000, 4:333-338doi:10.1186/cc717


Published:	6 November 2000

Abstract

A moribund and debilitated patient arrives in an emergency department and is placed on life support systems. Subsequently it is determined that she has a 'living will' proscribing aggressive measures should her condition be judged 'terminal' by her physicians. But, as our round table of authorities reveal, the concept of 'terminal' means different things to different people. The patient's surrogates are unable to agree on whether she would desire continuation of mechanical ventilation if there was a real chance of improvement or if she would want to have her living will enforced as soon it's terms were revealed. The problem of the potential ambiguity of a living will is explored.