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Withholding or Withdrawing Treatment

Harold Rosen, MD
Arch Intern Med. 1987;147(5):992-994. doi:10.1001/archinte.1987.00370050184034.
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To the Editor.  —I read with great interest the letter by Rosner in the January 1987 issue of the Archives1 regarding withholding nutritional support from dying patients. Rosner quoted the American Medical Association's position that "it is not unethical to discontinue... life-prolonging medical treatment, [which] includes medication... nutrition and hydration" in selected patients.2 Rosner objected to the position, giving the following insight: when a physician can offer nothing to cure a patient, his responsibility as a physician ends, and his responsibility to the patient becomes that of a regular moral lay person; that is, to comfort, visit, console, and feed the patient. Rosner then suggests that we need not give medication or transfusions to the dying patient, but we are obligated to nourish and hydrate the dying patient, as any moral layman would.While I find his guidelines for a physician's responsibility to the dying patient simple and


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