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Ann Thorac Surg 2002;74:1430-1431
© 2002 The Society of Thoracic Surgeons

Ethics in cardiothoracic surgery

Witnessing death as lifesaving treatment is withheld

Martin F. McKneally, MD, PhDa*

a Department of Surgery, Toronto General Hospital, University of Toronto Joint Center For Bioethics, Toronto, Ontario, Canada

* Address reprint requests to Dr McKneally, 77 Forest Grove Dr, Toronto, Ontario M2K 1Z4, Canada, USA.
e-mail: martin.mckneally@utoronto.ca

The first 20% of the full text of this article appears below.

Surgery is a warrior culture, whose practitioners are committed to battle heroically and physically against death and disease. Although the law protects caregivers from prosecution when they withhold lifesaving care at a patient’s request, they are not spared the moral anguish they experience when they are required to violate their own personal ethic of care. In this nearly tragic case, the surgeon used every means in his power to rescue his patient from certain death. In the aftermath, his surviving patient feels anger and resentment toward the surgeon, alleging that immoral means were used to save his life. Autonomy, the moral right to choose and follow one’s own plan of life and action, is a deeply embedded and dominant element in western culture, law, ethics, and medicine. Autonomous informed refusal of lifesaving care is an allowable and legitimate choice for mentally competent patients, particularly when they demonstrate a durable and firmly held conviction to refuse treatment and face their death steadfastly.

Religion is . . . [Full Text of this Article]




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