Journal Article

Is withdrawing treatment really more problematic than withholding treatment?

Savulescu, Julian, Wilkinson, Dominic, Cameron, James

2021

Overview

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.

• Publisher: BMJ Publishing Group Ltd and Institute of Medical Ethics,BMJ,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: allocation of healthcare resources / clinical ethics / Coronaviruses / COVID-19 / Criminal law / Criminal liability / Current Controversy / Decision Making / distributive justice / Ethics / Euthanasia / Hospitals / Humans / Intensive care / Medical ethics / Pandemics / Patients / Physicians / Practitioner patient relationship / Right to die / SARS-CoV-2 / Ventilation / Ventilators / Ventilators, Mechanical / Withholding Treatment