Theoretical Medicine

, Volume 5, Issue 2, pp 147–153 | Cite as

Death and dying: Reflections of an intensivist

  • Michael S. Jastremski


The prolonged life support of individuals with no hope for recovery has been an unfortunate consequence of recent advances in medical technology. The use of intensive therapy in such patients is contrary to the physician's obligation to relieve suffering and also creates an enormous economic burden for society. Once the physician has determined that there is no hope for a meaningful recovery, it becomes ethically correct for him to withhold or withdraw intensive therapy from that patient provided that such an action will not increase the patient's suffering.

Key words

Intensive care Life support systems Death Medical ethics Euthanasia Medical technology Prolongation of life 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. [1]
    Cassel, E. J.: ‘The nature of suffering and the goals of medicine’, New England Journal of Medicine 306, (1982) 639–645.Google Scholar
  2. [2]
    Grenvik, A., Powner, D. J., Snyder, J. V., Jastremski, M. S., Babcock, R. A., and Loughhead, M. G.: ‘Cessation of therapy in terminal illness and brain death’, Critical Care Medicine 6, (1978) 284–291.Google Scholar
  3. [3]
    Levy, D. E., Bates, D., Caronna, J. J., Cartlidge, N. E. F., Knill-Jones, R. P., Lapinski, R. H., Singer, B. H., Shaw, D. A., and Plum, F.: ‘Prognosis in nontraumatic coma’, Annals of Internal Medicine 94, (1981) 293–301.Google Scholar
  4. [4]
    McIntyre, K. M.: ‘Medicolegal aspects of cardiopulmonary resuscitation and emergency cardiac care’, in K. M. McIntyre and A. J. Lewis (eds.), Textbook of Advanced Cardiac Life Support, American Heart Association, Dallas, 1981, Chapter 18.Google Scholar
  5. [5]
    Parno, J. R., Teres, D., Lemeshow, S., and Brown, R. B.: ‘Hospital charges and long-term survival of ICU versus non-ICU patients’, Critical Care Medicine 10, (1982) 569–574.Google Scholar
  6. [6]
    Thompson, W. L.: ‘Critical care tomorrow: Economics and challenges’, Critical Care Medicine 10, (1982) 561–568.Google Scholar

Copyright information

© D. Reidel Publishing Company 1984

Authors and Affiliations

  • Michael S. Jastremski
    • 1
  1. 1.Critical Care and Emergency MedicineState University of New York, Upstate Medical CenterSyracuseU.S.A.

Personalised recommendations