Spinal Cord Injury, Life Sustaining Treatment, and Clinical Ethics—Nuances in Respecting and Understanding Autonomous Choice

Abstract

When a patient decides to forego life-sustaining treatment it can be a challenging situation for all parties involved. Patients who have decision-making capacity have the right to accept or refuse medical treatment. It is critical for clinicians to understand how to deal with these cases and what information and supports can be provided to patients to help them make fully informed and self-determining decisions. When a patient is facing a life with severe disability special considerations and an experienced approach are important in helping patients understand the full range of options. This case-based discussion will explore some of the issues involved in a scenario of a patient with a cervical spinal cord injury who requests to terminate his ventilator. Suggestions for managing situations such as these will be described.