Beyond Autonomy -- Physicians' Refusal to Use Life-Prolonging Extracorporeal Membrane Oxygenation

Three years ago it was noted that the literature on physicians' refusal to provide requested treatment was sparse, and since that time the issue has fueled an intense, two-pronged debate -- on futility and on the limits of patient autonomy.

Abstract

Conclusions: If after the physician has listened to the concern of\nthe family members and explored the possibilities with them -- including the\ntransfer of the patient to a willing physician -- the family persists in its\ndemands for continued life-prolonging treatment that the physician believes to\nbe beyond well-established medical criteria, the physician ought not to feel\nobliged to provide it. The physician's response in such cases should be: "I am\nsorry, but we don't do that here." This is done not because the patient no\nlonger has any value or because the physician lacks respect for the family's\nwishes. It is done because the obligation of physicians, as articulated in the\nHippocratic Oath, is to act for the benefit of the patient according to their\nability and judgment.