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Is withdrawing treatment really more problematic than withholding treatment?

Abstract:
There is a concern that as a result of COVID-19 there will be a shortage of ventilators for patients requiring respiratory support. This concern has resulted in significant debate about whether it is appropriate to withdraw ventilation from one patient in order to provide it to another patient who may benefit more. The current advice available to doctors appears to be inconsistent, with some suggesting withdrawal of treatment is more serious than withholding, while others suggest that this distinction should not be made. We argue that there is no ethically relevant difference between withdrawing and withholding treatment and that suggesting otherwise may have problematic consequences. If doctors are discouraged from withdrawing treatment, concern about a future shortage may make them reluctant to provide ventilation to patients who are unlikely to have a successful outcome. This may result in underutilisation of available resources. A national policy is urgently required to provide doctors with guidance about how patients should be prioritised to ensure the maximum benefit is derived from limited resources.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/medethics-2020-106330

Authors


More by this author
Institution:
University of Oxford
Division:
HUMS
Department:
Philosophy Faculty
Role:
Author
More by this author
Institution:
University of Oxford
Division:
HUMS
Department:
Philosophy Faculty
Oxford college:
Merton College
Role:
Author
ORCID:
0000-0003-3958-8633



Publisher:
BMJ
Journal:
Journal of Medical Ethics More from this journal
Volume:
47
Issue:
11
Pages:
722-726
Publication date:
2020-05-25
Acceptance date:
2020-05-04
DOI:
EISSN:
1473-4257
ISSN:
0306-6800
Pmid:
32451343


Language:
English
Keywords:
Pubs id:
1109548
Local pid:
pubs:1109548
Deposit date:
2020-07-13

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