Disconnecting a Ventilator at the Request of a Patient Who Knows He Will Then Die: The Doctor's Anguish
Authors: Miles J. Edwards, Susan W. Tolle
Journal: Annals of Internal Medicine (1992)

On Being a Doctor1 August 1992Disconnecting a Ventilator at the Request of a Patient Who Knows He Will Then Die: The Doctor's AnguishMiles J. Edwards, MD, Susan W. Tolle, MDMiles J. Edwards, MDSearch for more papers by this author, Susan W. Tolle, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-3-254 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRecently we assisted in withdrawing life support from a patient who had repeatedly asked to have his ventilator disconnected, even after being informed that he would then die. We found little in the medical literature to guide us, especially at the feeling level, so we are sharing our experience with the hope that others will find our emotional responses, reasoning, and procedures useful.The CaseMr. Larson was a 67-year-old, obese white man. At 23 years of age he developed poliomyelitis and "spent six weeks in an iron lung." His neurologic recovery was virtually complete, and he resumed a reasonably... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTransport Home and Terminal Extubation by Emergency Medical Services: An Example of Innovation in End-of-Life CareConscientious Non-objection in Intensive CareOpenings into Clinical EthicsDyspnea Can Be, and Should Be, Effectively Palliated with OpioidsZwischen Selbstbestimmung und FürsorgeHumane terminal extubation reconsideredTerminal Extubation of the Alert PatientAnticipation of distress after discontinuation of mechanical ventilation in the ICU at the end of lifeEthics, Informed Consent, and Decisions About Nonoral Feeding for Patients With DysphagiaEthical Issues in the Management of Dysphagia After StrokeOpioids and Benzodiazepines Appear Paradoxically to Delay Inevitable Death after Ventilator WithdrawalBecky's Legacy: Personal and Professional Reflections on Loss and HopeExtubation chez 5 patients en fin de vie en réanimationDelirium and sedationWithholding and Withdrawing of Life SupportPalliative Options of Last ResortVentilator withdrawal: procedures and outcomes. Report of a collaboration between a critical care division and a palliative care serviceHandeln und Unterlassen in der neurologischen IntensivbehandlungOn what are our end-of-life decisions based?Regarding the Unkind Death of Billie BelleSusan W. Tolle, MD and Virginia Tilden, RN, DNSc""Pulling the Plug""Ethical Challenges in the Care of Patients with Serious IllnessEutanasia y cuidados paliativos: ¿amistades peligrosas?Pain in medical illness: ethical and legal foundationsResponding to Legal Requests for Physician-Assisted SuicideJames A. Tulsky, MD, Ralph Ciampa, STM, and Elliott J. Rosen, EdD, for the University of Pennsylvania Center for Bioethics Assisted Suicide Consensus PanelTerminal weaning from mechanical ventilationEthical considerations relating to terminal weaning in intensive careWithdrawing Intensive Life-Sustaining Treatment — Recommendations for Compassionate Clinical ManagementSlow EuthanasiaVariations in the Use of Do-Not-Resuscitate Orders in ICUsChanges in Forgoing Life-Sustaining Treatments in the United States: Concern for the FuturePHYSICIANS, ETHICS, ADVANCE DIRECTIVES, AND LONG-TERM CARETHE LANGUAGE OF DEATH: EUTHANATOS ET MORSThe Combative Patient: Ethical Issues in Patient Selection for Chronic DialysisNurses'definitions of and attitudes towards euthanasiaDeath can be proudLONG-TERM CARE, REHABILITATION, AND LEGAL AND ETHICAL CONSIDERATIONS IN THE MANAGEMENT OF NEUROMUSCULAR DISEASE WITH RESPIRATORY DYSFUNCTIONIn replyThe Clinical Management of Dying Patients Receiving Mechanical VentilationDiscontinuing an implantable cardioverter defibrillator as a life-sustaining treatmentEuthanasia and Assisted Suicide: Is Mercy Sufficient?The hospice advantageEthical issues in palliative care - an overviewTrends from the United States with end of life decisions in the intensive care unitEthische und rechtliche Grundlagen 1 August 1992Volume 117, Issue 3Page: 254-256KeywordsBioethicsEmotionsHealth careLungsOverweightPoliomyelitisReasoningVentilators Issue Published: 1 August 1992 Copyright & Permissions© 1992 American College of PhysiciansPDF downloadLoading ...