Refusing care

Refusing care

Regarding the case of Betancourt v. Trinitas, I believe your report is incorrect when it states that the hospital’s position favoring discontinuation of care “runs counter to most settled law” (“NJ appeals court hears end-of-life arguments,” May 6).

It is true that the law appropriately gives patients and those acting on their behalf the right to refuse care, but there is no law that obligates hospitals or health care providers to administer care that is futile or otherwise not in the patient’s interest, even when demanded by patients or their proxies. (There is one notable exception: In some states a “do not resuscitate” order cannot be implemented without the patient’s permission.) The law does not, for example, require a surgeon to perform an operation or an oncologist to administer a course of chemotherapy if, in their professional opinion, treatment is not likely to make the patient better or significantly prolong life. The withdrawal of life-sustaining care such as ventilators against the wishes of the patient or family is ethically much more complex, but under the proper circumstances can be legal as I understand it.

Lewis J. Kampel, M.D.
New York, NY

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