End of Life: Treatment Redirection

Authors explore the ethical considerations in terminal aggressive curative treatment and moving toward aggressive palliative care.

Bioethics Forum Vol. 14 (2) Summer 1998

Treatment Redirection: Moving from Curative to Palliative Care
Robert Potter offers clues by which we can recognize, deliberate and implement the process of redirection.

The Houston Process-Based Approach to Medical Futility
Amir Halevy and Baruch A. Brody report on the development and implementation of a process-based approach of determining medical futility.

Community Guidelines for End-of-Life Care: Incremental Change or Significant Reform
Advance directives and outcomes research are two widely used, but insufficient, tools for improving end-of-life care. The Colorado Collective for Medical Decisions strongly supports their use but only as supplemented by the development of clinical care guidelines capable of dealing with both futile and marginally effective healthcare situations.

A Meditation – May I Be a Cancerous Survivor
Bill Bartholome concludes that Death and God are cut from the same cloth. “For me, living with death on my shoulder feels a good deal like what I have always thought it would be like to live with God on one’s shoulder. To bend one’s ear toward Death is to listen for the voice of God.”

Considerations Regarding Withholding/Withdrawing Life-Sustaining Treatment
The Kansas City Area Ethics Committee Consortium proposes these considerations for forgoing life-sustaining treatments to be used by ethics committees as they assist in the development of policies within their institutions.

Case Study: Barney Says No
Does it make a difference which stakeholder – the patient or the surrogate – raises the question about treatment redirection?

Practical Bioethics, Vol 2, No. 2 and 3, Summer 2006

The Ethics of Artificial Nutrition and Hydration – A Practical Guide
This issue of Practical Bioethics explores the sensitive and practical concerns surrounding artificial nutrition and hydration. What are our obligations to save, to treat, to care for, and to protect those whose life are at ebb tide? How do we value life and simultaneously “let go” to honor the wishes of those who would forgo artificial nutrition and hydration? How do we determine the best interests of those who have not provided evidence of their healthcare wishes?