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Wilhholding or withdrawing treatment

Zana Zana (Member)

Which health care members are involve in the decision making when it comes to withholding or withdrawing treatment within the ICU setting?

Who is the Senior member of the team who takes responsibility for the decision with rationale.

Grace Oz

Specializes in Med/Surg/Ortho/HH/Radiology-Now Retired.

More often than not, it's the treating doctor/s.

There usually has to be consultation with the patient's NOK.

In some cases, a court order obtained.

Nurses only carry out the orders, not make the decisions.

In most instances, nurses, by law, do not make diagnosis nor decisions on whether to withhold treatment or not. That is not the role of the nurse. Certainly in Australia anyway.

If there's any discrepancy to this, I stand corrected.

I am not sure quite where you are heading with this question

The recent court decision in Melbourne re the woman with MS and have a gatric feeding tube will have an affect l think in regard to some cases but l do not beleive in the ICU situation - however with the advent of medical and living wills this maybe ultimately taken out of medical personal 's hands - any other thoughts out there.


Not necessarily...........

Would that be the hospital God, the doctor God, the administrator God, the Right Honourable Justice God, the political statesman God, the political leader God, the head of state God or the plebian voter God?

:cool: Generally in our ICU we have a series of protocols which are adhered to, all ICUs have them, the first step is the treating team, and then the ICU director, however......care must be taken to find out if the person has an Advanced Health Directive, if this is the case, then the persons contracted instructions take precedence. A person must be in sane mind to undertake an Advanced Health Directive, this does not mean they can't have one of they can't write, I believe it can be done by proxy in the presence of a Notary Public.

gwenith, BSN, RN

Specializes in ICU.

We rarely have anyone with a pre-written Advanced Health Directive and when it comes to the final decision it is often done by the consultant after prolonged discussion with the family. We have had one case of a patient who refused further treatment - asked ETT and vent be withdrawn and we allowed him to day goodbye to the family the way he wanted to.

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