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Withholding or Withdrawing Treatment-Reply

Fred Rosner, MD, FACP
Arch Intern Med. 1987;147(5):994. doi:10.1001/archinte.1987.00370050186035.
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—Rosen misrepresents my position when he states that I suggested that "we need not give medication or transfusions to the dying patient." Pain relief is an obligation that the physician must provide his dying patient to the very end. Similarly, if a blood transfusion for an anemic patient can increase the patient's comfort and improve the patient's breathing by enhancing oxygen-carrying capacity, it may well be indicated even in a dying patient. Standard therapeutic modalities must be given to dying patients if they can benefit them. Experimental therapy is obviously not obligatory, but is up to the patient to decide.

Regarding the discontinuation of nutritional support from some patients, I consider such an approach morally wrong. Food and fluid given to a dying patient does not become medical therapy because another person is needed to provide it. Would Rosen suggest that handicapped persons not able to swallow because of some


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