Case studies of legal intervention in end-of-life care in the intensive care unit

  • A. Lefebvre


Disputes regarding withdrawal of life support have become a common occurrence in the intensive care unit (ICU). When there is a conflict between a patient (or if the patient is not competent, his family) and the health-care team regarding end-of-life decisions in the ICU, reliance upon legal solutions should remain a last resort. Introducing an adversarial method of conflict resolution is completely at odds with the ethical principles of providing appropriate care to dying patients. Examination of two case studies will highlight the inadequacies of the law in dealing with such matters.


Intensive Care Unit Amyotrophic Lateral Sclerosis Medical Malpractice Persistent Vegetative State Balance Decision 


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  1. Somerville MA (2000) The ethical canary: science, society and the human Spirit. Toronto Penguin BooksGoogle Scholar


  1. Roy D et al (1981) Whose life is it anyway? McGill J 26: pp. 1068–1083Google Scholar
  2. Somerville MA (1981) Structuring the issues in informed consent. McGill Law J 26:740–808PubMedGoogle Scholar
  3. Dickens BM (1981) The right to natural death. McGill Law J 26:847–879PubMedGoogle Scholar
  4. Truog RD et al (1992) Sounding board: the problem with futility. N Engl J Med 32b: 1560CrossRefGoogle Scholar
  5. McCrary van S et al (1994) Physician’s quantitative assessments of medical futility, J Clin Ethics, p. 100Google Scholar
  6. Youngner S (1988) Who defines futility, JAMA, 260:2094PubMedCrossRefGoogle Scholar


  1. David, Coroner A-M. Report on the inquest into the death of Herman Krausz. File No. 97345, Opinion No. A-125446. 18 November 1999Google Scholar
  2. Joint statement on preventing and resolving ethical conflicts involving health care providers and persons receiving care. Approved by the CMA Board of Directors, December 4–5, 1998Google Scholar
  3. Lazar, Dr. Neil M., Expert report dated April 18, 1999 prepared for Me Annette Lefebvre and Me Peter Kalichman for the Coroner’s Inquest into the death of Herman KrauszGoogle Scholar
  4. Model policy on appropriate use of life sustaining treatment proposed in March 1999 by the American Medical Association on Ethical and Judicial AffairsGoogle Scholar
  5. Somerville, Margaret A. Expert report dated March 4, 1999 prepared for Me Annette Lefebvre and Me Peter Kalichman for the Coroner’s Inquest into the death of Herman KrauszGoogle Scholar
  6. The Ethics Committee of the Society of Critical Care Medicine. Consensus Statement of the Society of Critical Care Medicine’s Ethics Committee Regarding Futile and Other Possibly Inadvisable Treatments. Published in Critical Care Medicine, vol. 25, no. 5 (1997) 887–891CrossRefGoogle Scholar

Cases: Canada

  1. Nancy B. vs. Hôtel-Dieu de Québec, (1992) R.J.Q. 361; 86 D.L.R. (4th) 385 (Quebec Superior Court) (translation from French)Google Scholar
  2. Rodriguez vs. Canada (AG) (1993) 3 S.C.R. 519; 107 D.L.R. 342 (Supreme Court of Canada)Google Scholar
  3. Sawatsky, A.vs. Riverview Health Centre Ine (1998) 167 D.L.R. (4th) 359Google Scholar

United States of America

  1. Brophy vs. New England Sinai Hospital, 497 N.E. 2d 626 (Mass. 1986)Google Scholar
  2. Cmzan vs. Director, Missouri Department of Health, 110 S. Ct. 2841 (1990)Google Scholar
  3. In RE Dinnerstein, 380 N.E. 2d 134 138 (Mass. App. Ct. 1978)Google Scholar
  4. In the Matter of Quinlan, 355 A. 2d 647 (N.J. 1976)Google Scholar
  5. In the of Conroy, 486 A. 2d 1209, 1232 (N.J. 1985)Google Scholar
  6. Superintendant of Belchertown State School c. Saikevicz, 370 N.E. 2d 417 (1977)Google Scholar

Copyright information

© Springer-Verlag Italia 2003

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  • A. Lefebvre

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