Ethical Decisions in Terminal Illness

  • D. Kettler
  • M. Mohr
Conference paper
Part of the Topics in Anaesthesia and Critical Care book series (TIACC)


Ethical decisions in terminal illness involve conflicts such as whether to withhold or to withdraw treatment, to perform a resuscitative attempt, or to allocate limited and expensive resources. Decision making has been complicated by the rapid progress in technology in intensive care and emergency medicine. A terminally ill patient is frequently unable to communicate and to express his or her will and preferences. Physicians often become a surrogate decision maker and have the responsibility of deciding whether to limit or withhold futile care. However, in terminal illness the definition of futility is not clear and is still a matter of discussion. Therefore, in the intensive and palliative care setting consensus among the diverse group of health care professionals is especially relevant. Despite a wide variety of personal beliefs and cultural and religious differences, decisions in ethical conflicts should be based on generally accepted principles such as respect for autonomy, beneficence, nonmaleficence, and justice.


Palliative Care Ethical Decision Ethical Theory Moral Rule Terminal Illness 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Beauchamp TL, Childress JF (1994) Principles of biomedical ethics, 4th ed. Oxford University Press, New YorkGoogle Scholar
  2. 2.
    Engelhardt HT Jr (1996) The foundations of bioethics, 2nd ed. Oxford University Press, New YorkGoogle Scholar
  3. 3.
    Murphy DJ, Burrows D, Santilli S et al (1994) The influence of the probability of survival on patients’ preferences regarding cardiopulmonary resuscitation. N Engl J Med 330: 545–549PubMedCrossRefGoogle Scholar
  4. 4.
    Task Force on Ethics of the Society of Critical Care Medicine (1990) Consensus report on the ethics of foregoing life-sustaining treatments in the critically ill. Crit Care Med 18: 1435–1439CrossRefGoogle Scholar
  5. 5.
    Thomas PD, Runciman WB (1996) Ethical Issues. In: Johnston JR (ed) International handbook of Intensive Care. Euromed Communications,Belfast, pp 1–12Google Scholar
  6. 6.
    Snider GL (1991) The do-not-resuscitate order. Ethical and legal imperative or medical decision? Am Rev Respir Dis 143: 665–674PubMedGoogle Scholar
  7. 7.
    Crimmins TJ (1993) Ethical issues in adult resuscitation. Ann Emerg Med 22: 495–501CrossRefGoogle Scholar
  8. 8.
    The Ethics Committee of the Society of Critical Care Medicine (1997) Consensus statement of the Society of Critical Care Medicine’s Ethics Committee regarding futile and other possibly inadvisable treatments. Crit Care Med 25: 887–891Google Scholar

Copyright information

© Springer-Verlag Italia, Milano 2001

Authors and Affiliations

  • D. Kettler
  • M. Mohr

There are no affiliations available

Personalised recommendations