Withholding and Withdrawing Treatment

  • Franz Josef Illhardt
Part of the International Library of Ethics, Law, and the New Medicine book series (LIME, volume 8)


First of all, I would like to outline the use of the terms ‘withholding treatment’ and ‘withdrawing treatment’. They belong to the conceptual category of ‘medical decisions at the end of life’, including euthanasia. In contrast to killing, euthanasia only takes place when death is imminent — then and only then. To withhold treatment implies not initiating the treatment. To withdraw life support systems and procedures implies discontinuing a method of treatment, which was initiated to support life, but in the meantime has proven its uselessness and now serves only to prolong life, or rather: to prolong the process of dying.


Advance Directive Ethic Consultation Health Care Ethic Active Euthanasia Futile Treatment 
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  1. Ariès, Ph.: 1975, Essais sur l’histoire de la mort en Occident du moyen-dge d nos jours. Edition du Seuil, Paris.Google Scholar
  2. Bacon, F.: 1958, De dignitate et augmentis scientiarum [1623]. Spedding, J.D., Ellis, L.R. and Heath, D.D. (eds.): The works of F. Bacon. Longman, London. Vol. 1, p. 421–837.Google Scholar
  3. Baines, M.J.: 1992, Symptom management and palliative care. In: Evans, J.G. and Williams, T.F. (eds.): Oxford Textbook of Geriatric Medicine. Oxford University Press, Oxford/New York/Tokyo, p. 685–696.Google Scholar
  4. Birnbacher, D.: 1995, Tun und Unterlassen. Reclam, Stuttgart.Google Scholar
  5. Brenahan, J.F.: 1994, Advance directive in the 1990s: Medical care of the dying and the myth of Sisiphus. In: Monagle, J.F. and Thomasma, D.C. (eds.): Health Care Ethics. Critical Issues. Aspen Publishers, Gaithersburg, p. 213–216.Google Scholar
  6. Clarke, D.B.: 1994, The patient self-determination act. In: Monagle, J.F. and Thomasma, D.C.Google Scholar
  7. Health Care Ethics. Critical Issues. Aspen Publishers, Gaithersburg, p. 93–108.Google Scholar
  8. Dallas, M.H.: 1987, Planning for decisional incapacity. A neglected area in ethics and aging.Google Scholar
  9. Journal of the American Geriatrics Society 35: 814–20.Google Scholar
  10. Duff, R.S.: 1988, Unshared and shared decisionmaking. In: King, N.M.P., Churchill, L.R. and Cross, A.W. (eds.): The physician as captain of the ship: a critical reappraisal. Reidel, Dordrecht/Boston, p. 191–221.CrossRefGoogle Scholar
  11. Fletcher, J.C., Quist, N. and Jonsen, A.R. (eds.): 1989, Ethics consultation in health care. Health Adminstration Press, Ann Arbor.Google Scholar
  12. Gutheil, T.G., Bursztajn, H. and Brodsky, A.: 1984. Malpractice prevention through the sharing of uncertainty. Informed consent and the therapeutic alliance. New England Journal of Medicine 311: 49–51.CrossRefGoogle Scholar
  13. Hill, T.P.: 1994, Ethical issues in the use of fluids and nutrition: When can they be withdrawn? In: Monagle, J.F. and Thomasma, D.C. (eds.): Health Care Ethics. Critical Issues. Aspen Publishers, Gaithersburg, p. 217–225.Google Scholar
  14. Illhardt, F.J.: 1996, Wem gehört der Mensch? Erwägungen über Besitzrechte am eigenen Körper. Berliner Medizinethische Schriften Heft 3, Humanitas Verlag, Dortmund.Google Scholar
  15. Illhardt, F.J.: 1994, Das Selbstbild des Arztes: `Missing Link’ zwischen Ideal und Praxis? In: Leven, K.-H. and Prüll, C.-R. (eds.): Selbstbilder des Arztes im 20. Jahrhundert. Medizinhistorische und medizinethische Aspekte. (Freiburger Forschungen zur Medizingeschichte. Est. Aschoff, L. Ed. by Seidler, E. and Kuhlo, B. Neue Folge Bd. 16 ) HF Schulz, Freiburg, p. 137.Google Scholar
  16. Jaspers, K.: 1986, Die Idee des Arztes. In: Jaspers, K. (ed.): Der Arzt im technischen Zeitalter. Piper, Mainz/München, p. 7–18.Google Scholar
  17. Jens, W.: 1995, Si vis vitam para mortem. Die Literatur über Würde und Würdelosigkeit des Sterbens. In: Jens, W. and Küng, H.: 1995, Menschenwürdig sterben: ein Plädoyer fir Selbstverantwortung. Piper, München, p. 87–129.Google Scholar
  18. Keenan, J.F.: 1996, The concept of sanctity of life and its use in contemporary bioethical discussion. In: Bayert, K. (ed.): Sanctity of life and human dignity. Kluwer Academic Publishers, Dordrecht/Boston/London, p. 1–18.CrossRefGoogle Scholar
  19. Klaschik, E. and Sandgathe-Husebö, B.: 1998, Das Leben des Sterbenden–Palliativmedizin. In: Illhardt, F.J., Heiss H.W. and Dornberg, M. (eds.): Sterbehilfe–Handeln oder unterlassen? Schattauer, Stuttgart, p. 105–111.Google Scholar
  20. Küng, H.: 1995, Menschwiirdig Sterben. In: Jens, W. and Küng, H.: 1995, Menschenwürdig sterben: ein Plädoyer für Selbstverantwortung. Piper, München, p. 13–85.Google Scholar
  21. MacKay, C.R.: 1991, The physician as fortune teller. A commentary on `the ethical justification for minimal paternalism’. Journal of Clinical Ethics 2: 228–238.Google Scholar
  22. Pellegrino, E.D.: 1989, Withholding and withdrawing treatments: Ethics at the bedside. Clinical Neurology 35: 164–184.Google Scholar
  23. Pellegrino, E.D.: 1993, A philosophy of finitude: Ethics and the humanities in the allocation of resources. In: Winslow, G.R. and Walters, J.W. (eds.): Facing limits. Westview, Boulder, p. 31–53.Google Scholar
  24. Printz, L.A.: 1988, Is withholding hydration a valid comfort measure in the terminally ill? Geriatrics 43: 84–87. Google Scholar
  25. Schöne-Seifert, B. and Eickhoff, C.: 1996, Behandlungsverzicht bei Schwerstkranken: Wie würden Arzte und Pflegekräfte entscheiden? Eine Vignettenstudie. Zeitschrift für Ethik in der Medizin 8: 183–216.Google Scholar
  26. Seale, C. and Pattison S. (eds.): 1994, Medical knowledge: doubt and certainty (Completely rev. version). Open University Press, Buckingham.Google Scholar
  27. Stähelin, H.B.: 1993, Flüssigkeitszufuhr bei terminalen geriatrischen Patienten. Schweizerische Rundschau für Medizin (Praxis) 82: 792–94.Google Scholar
  28. Steinbeck, J.: 1952, East of Eden. Viking Press, New York.Google Scholar
  29. Thomasma, D.C.: 1992, Models of the doctor-patient relationship and the ethics committee: Part one. Cambridge Quarterly of Health Care 1: 11–31. Google Scholar
  30. Truog, R.D., Brett, A.S. and Frader, J.: 1992, The problem with futility. New England Journal of Medicine 326: 1560–64. Google Scholar
  31. Watzlawick, P.: 1986, Vom Schlechten des Guten. Oder Hekates Lösungen. Piper, München. Wehkamp, K.-H.: 1998, Therapieverzicht: Dilemmata ärztlichen Entscheidens. In: Illhardt, FJ.Google Scholar
  32. Heiss, H.W. and Dornberg, M. (eds.): Sterbehilfe - Handeln oder unterlassen? Schattauer, Stuttgart, p. 25–33.Google Scholar
  33. Yellen, S.B., Elpern, E.H. and Burton, L.A.: 1994, Patient concerns about advance directives. In: Monagle, J.F. and Thomasma, D.C. (eds.): Health Care Ethics. Critical Issues. Aspen Publishers, Gaithersburg, p. 109–115.Google Scholar

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© Springer Science+Business Media Dordrecht 2001

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  • Franz Josef Illhardt

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