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Thursday, October 31, 2013

End of Life Care: Withholding Antibiotics

A few weeks ago I had a discussion with my good friend, Melissa Brown, A Law School Professor who teaches Elder Law and Social Policy, and expert in workers' compensation law. We discussed End of Life Care , and the withholding of antibiotics to treat infections. The moral and ethical issues are far reaching when balancing the quality of life issues in older patients.  Today post is shared from . I would encourage readers to read the entire article and linked material as the important issue will soon be in the forefront of care protocols in the US.

The UK Supreme Court [official website] ruled [judgment, PDF; press release, PDF] Wednesday that Aintree University Hospitals NHS Foundation Trust [official website] was justified in its decision that withholding certain invasive treatments would be in the best interests of critical care patient David James, despite resistance from the patient's family. James was admitted to Aintree's critical care unit in May 2012 for an infection acquired during his treatment for colon cancer, where he was reliant on ventilator support and suffered multiple severe setbacks. Despite opposition from James' family, the hospital brought proceedings to the Court of Protection [official website] in September 2012. The hospital sought judicial declaration that withholding the specified treatments would be in James' best interest, pursuant to the 2005 Mental Capacity Act [text, PDF; Code of Practice] provision that it may in the best interests of a patient to withhold life-sustaining treatment "where treatment is futile, overly burdensome to the patient or where there is no prospect of recovery." The trial judge ruled against the declarations on December 6, and Aintree appealed. James subsequently suffered "further dramatic deterioration," and the Court of Appeal reversed [judgment, PDF] the decision on December 21, 2012. James died of cardiac arrest only 10 days later. Wednesday's ruling by the Supreme Court subsequently determined that the trial judge was correct in opposing the declarations and that the Court of Appeal was also correct in light of the changed circumstances since the initial ruling.

Click here to read the entire article.