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Moral and religious objections by hospitals to withholding and withdrawing life-sustaining treatment

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Abstract

A patient's right to decide about life-sustaining treatment may conflict with the policies of health care facilities that refuse on the basis or religious or moral convictions to honor certain decisions to forgo treatment. The New York State Task Force on Life and the Law examined the prevalence and nature of facility conscience objections to the refusal of life-sustaining treatment by conducting a survey of New York hospitals. Written questionnaires were distributed to hospitals in New York State. Fifty-eight percent of the New York State hospitals responded. Twenty-nine percent of the respondents indicated that their hospital would object on grounds of conscience either to withholding or to withdrawing life-sustaining treatment in at least one of the twelve hypothetical cases presented. Hospitals were more likely to have “no policy” for withdrawing than for withholding treatment. Only 10% of the hospitals that would object to decisions to forgo treatment on religious or moral grounds had stated the objections in writing. The patient's medical condition and the type of life-sustaining treatment to be withdrawn or withheld are important factors in determining whether a hospital will object on grounds of conscience. The imminence of death appeared more decisive than the degree of debilitation or disability as a factor in the willingness to accept decisions to forgo life-sustaining treatment. Hospitals should establish clear, written policies about their objections to forgoing treatment so that patients and their families can evaluate whether the facility meets their needs.

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References

  1. See generally: Weir, RF, Gostin, L, Decisions to abate life-sustaining treatment for nonautonomous patients.JAMA 264: 1846–53, 1990.

    Article  PubMed  Google Scholar 

  2. Society for the Right to Die:Handbook of Living Will Laws. New York: 1987 and supplements.

  3. In re Quinlan, 70 N.J. 10, 355 A.2d 647,cert. denied sub nom. Garger v. New Jersey, 429 U.S. 922 (1976).

  4. Satz v. Perlmutter, 379 So. 2d 359 (Fla. 1980).

  5. Rassmusen v. Fleming, 154 Ariz. 207, 741 P.2d 674 (1987) (en banc).

  6. 110 S. Ct. 2841 (1990).

  7. In re Eichner, 52 N.Y.2d 363, 438 N.Y.S.2d 266,cert denied, 454 U.S. 858 (1981).

  8. See generally, Areen, J, The Legal status of consent from families of adult patients to withdraw or withhold treatment.JAMA 258: 229–35, 1987.

    Article  PubMed  Google Scholar 

  9. Annas GJ, Transferring the ethical hot potato.Hastings Cent Rep 17: 20–1, 1987.

    Google Scholar 

  10. Miles SH, Singer PA, and Siegler M, Conflicts between patient's wishes to forgo treatment and the policies of health care facilities.N Engl J. Med. 321: 48–50, 1989.

    PubMed  Google Scholar 

  11. Brophy v. New England Sinai Hospital, Inc., 398 Mass. 417, 497 N.E.2d 626 (1986).

  12. 213 N.J. Super. 475, 517 A.2d 886 (Ch. Div.)affd, 213 N.J. Super. 443, 517 A.2d 869 (App. Div. 1986.)

  13. Patient Self-Determination Act, Pub. L. No. 101-508, §§ 4206 and 4751 (1990).

  14. N.Y. Public Health Law, Article 29-C, §2984 (1990).

  15. Mass. Gen. L. ch. 201D, § 15 (1990).

  16. Exec. Order No. 56, December 1984. The Task Force was convened in 1985 to develop recommendations for public policy on a range of issues arising from recent medical advances, including the withdrawal and withholding of life-sustaining treatment.

  17. Elbaum v. Grace Plaza of Great Neck, 148 A.D.2d 244, 544 N.Y.S.2d 840 (2d Dep't 1989).

  18. Fleiss JL:Statistical Methods for Rates and Proportions, 2nd ed. New York: Wiley, 1981. P. 120.

    Google Scholar 

  19. Cupples LA, Heeren T, Schatzkin A, and Colton T, Multiple testing of hypotheses in comparing two groups.Ann Intern Med. 100: 122–9 1984.

    PubMed  Google Scholar 

  20. President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research:Deciding to Forego Life-sustaining Treatment—Ethical, Medical and Legal Issues in Treatment Decisions. Washington D. C.: Government Printing Office, 1988. P. 77.

    Google Scholar 

  21. Beauchamp TL, Childress, JF:Principles of Biomedical Ethics, 3rd Ed. New York: Oxford University Press, 1989, P. 147.

    Google Scholar 

  22. Johnson AR, Siegler M, William JW:Clinical Ethics, A Practical Approach to Ethical Decisions in Clinical Medicine, 2nd Ed. New York: Macmillan Publishing Co., 1986. Pp. 107–8.

    Google Scholar 

  23. Ruark JE, Raffin TA, the Stanford University Medical Center Committee on Ethics, Initiating and withdrawing life support—principles and practice in adult medicine.N Engl J Med. 318: 25–30, 1988.

    PubMed  Google Scholar 

  24. In re Jobes, 108 N.J. 394, 529 A.2d 434 (1987).

  25. Miller TE, Public policy in the wake of Cruzan: A case study of New York's health care proxy law.Law, Medicine & Health Care 18: 360–7, 1990.

    Google Scholar 

  26. New York State Task Force on Life and the Law:When Others Must Choose—Deciding for Patients Without Capacity. New York: New York State Task Force on Like and the Law, 1992.

    Google Scholar 

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Statistical consultation and review was provided by Bruce Levin, PhD, Division of Biostatistics, Columbia University School of Public Health and Jeff Sobal, PhD, Division of Nutritional Sciences, Cornell University.

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Cugliari, A.M., Miller, T.E. Moral and religious objections by hospitals to withholding and withdrawing life-sustaining treatment. J Community Health 19, 87–100 (1994). https://doi.org/10.1007/BF02260361

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