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Commentary

Ethics roundtable debate: should a sedated dying patient be wakened to say goodbye to family?

Anna Batchelor1, Leslie Jenal2, Farhad Kapadia3, Stephen Streat4, Leslie Whetstine5 and Brian Woodcock6 email

1Consultant, Anaesthesia and Intensive Care Medicine, Royal Victoria Infirmary, Newcastle, UK

2Chaplain, Pasadena, California, USA

3Consultant Physician and Intensivist, PD Hinduja National Hospital, Bombay, India

4Intensivist, Department of Critical Care Medicine, Auckland Hospital, Auckland, New Zealand

5PhD Candidate, Centre for Healthcare Ethics, Duquesne University, Pittsburgh, Pennsylvania, USA

6Clinical Assistant Professor, Anesthesiology and Critical Care, University of Michigan Health System, Ann Arbor, Michigan, USA

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Critical Care 2003, 7:335-338doi:10.1186/cc2329

Published: 9 June 2003

Abstract

Intensivists have the potential to maintain vital signs almost indefinitely, but not necessarily the potential to make moribund patients whole. Current ethical and legal mandates push patient autonomy to the forefront of care plans. When patients are incapable of expressing their preferences, surrogates are given proxy. It is unclear how these preferences extend to the very brink of inevitable death. Some say that patients should have the opportunity and authority to direct their death spiral. Others say it would be impossible for them to do so because an inevitable death spiral cannot be effectively palliated. Humane principles dictate they be spared the unrelenting discomfort surrounding death. The present case examines such a patient and the issues surrounding a unique end-of-life decision.


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