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Withholding and Withdrawing Life Support

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Book cover Legal Aspects of Medicine

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Abstract

Intensive care units have become a routine part of modern American medicine during the past 3 decades. Presently, it is estimated there are more than 60,000 intensive care unit (ICU) beds in America, and these beds account for approximately 35 billion dollars in health care costs per year. Because of the widespread availability of mechanical ventilators, dialysis machines, and cardiovascular support technique extraordinary life support is commonplace. Furthermore, the lay public is quite aware of the struggle for life and death which takes places in intensive care units. Along with the development of life support techniques have come the perplexing ethical issues dealing with whether or not to withhold or withdraw life support. Many patient cases have been adjudicated in courts of law and thus there is now a significant body of law that deals with withholding and withdrawing life support. This chapter addresses the medicolegal aspects of withholding and withdrawing life support. Initially, we review recent legal trends and precedents involving life support. Following this we suggest general and specific principles to promote effective decision making. Finally, we use these principles to examine four common clinical situations dealing with life support: initiating basic life support, initiating advanced life support, withdrawing advanced life support, and withdrawing basic life support.

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Authors
  1. Thomas A. Raffin MD
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  2. Herbert Dicker JD
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  3. Jeffrey D. Robertson JD
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Editor information

Editors and Affiliations

  1. Pulmonary Lab, Flushing Medical Center, USA

    James R. Vevaina MD, FACP, FCCP (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant) (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant)

  2. Albert Einstein College of Medicine, Bronx, NY, USA

    James R. Vevaina MD, FACP, FCCP (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant) (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant)

  3. Pulmonary division, Long Island Jewish-Hillside Medical Center, New Hyde Park, NY, USA

    James R. Vevaina MD, FACP, FCCP (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant) (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant)

  4. State of New York and Consolidated Edison Corporation, USA

    James R. Vevaina MD, FACP, FCCP (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant) (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant)

  5. Flushing Hospital and Medical Center, 4500 Parsons Boulevard, Flushing, NY, 11355, USA

    James R. Vevaina MD, FACP, FCCP (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant) (Acting Chief, Critical Care Medicine and Associate Director, a major teaching affiliate, Consultant)

  6. Department of Internal Medicine and Critical Care Medicine, Rush Medical College, Chicago, IL, 60612, USA

    Roger C. Bone MD, FACP, FCCP (The Ralph Crissman Brown Professor and Chairman) (The Ralph Crissman Brown Professor and Chairman)

  7. Appellate Term of the Supreme Court of the State of New York, 2nd and 11th Judicial Districts, USA

    Edwin Kassoff (Presiding Justice, Professor of Law) (Presiding Justice, Professor of Law)

  8. Pace University, USA

    Edwin Kassoff (Presiding Justice, Professor of Law) (Presiding Justice, Professor of Law)

  9. 88-11 Sutphin Boulevard, Jamaica, NY, 11435, USA

    Edwin Kassoff (Presiding Justice, Professor of Law) (Presiding Justice, Professor of Law)

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© 1989 Springer-Verlag New York Inc.

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Raffin, T.A., Dicker, H., Robertson, J.D. (1989). Withholding and Withdrawing Life Support. In: Vevaina, J.R., Bone, R.C., Kassoff, E. (eds) Legal Aspects of Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-4534-6_23

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  • DOI: https://doi.org/10.1007/978-1-4612-4534-6_23

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-8867-1

  • Online ISBN: 978-1-4612-4534-6

  • eBook Packages: Springer Book Archive

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