Ethical aspects of care – Withdrawal of treatment at the end of life

Abstract

In progressive life-shortening neurological illness such as motor neurone disease, treatments are sometimes used to prolong life. In advancing disease it is sometimes found that these treatments are not working, that they are causing harm, or that consent is withdrawn. To consider withdrawal sometimes raises ethical concerns in health professionals’ minds. If it’s not working, shouldn’t we just try harder? Would stopping be even more harmful? Will the withdrawal hasten death? What if this is assisting suicide or even euthanasia? This session will take some of the ethical considerations in the use of these treatments as a starting point to examine the ethics of their withdrawal. It will draw on published guidance, academic literature and clinical experience to address the questions and concerns and to see what ethics can tell us about whether and how to consider, communicate and make decisions about life sustaining treatment and its withdrawal and how to support teams’ understanding and confidence. It will show that withdrawal of treatment, done properly, can be ethical and does not cause death.