Deciding about treatments that prolong life
Sometimes after injury or a long illness, the main organs of the body no longer work properly without support. Your doctor may tell you that these organs will not repair themselves.
Medical care to prolong life can keep you alive when these organs stop working well. The treatments extend your life, but do not cure your illness. These are called life-sustaining treatments.
Treatments to extend life can include the use of machines. This equipment does the work of the body organ, such as:
Making the decision for yourself
If you are near the end of your life or you have an illness that will not improve, you can choose what kind of treatment you want to receive.
You should know that removing the life support equipment does not end life: the illness or the injury is the cause of the end of life.
To help with your decision:
- Talk to your health care providers to learn about life support care you are receiving or may need in the future.
- Learn about the treatments and how they would benefit you.
- Learn about side effects or problems the treatments might cause.
- Think about the quality of life you value.
- Ask your doctor what happens if life support care is stopped or you choose not to start a treatment.
- Find out if you will have more pain or discomfort if you stop life support care.
These can be hard choices for you and those close to you. There is no hard and fast rule about what to choose. People's opinions and choices often change over time.
How to make your wishes known
To make sure your wishes are followed:
- Talk to your health care providers about your choices.
- Write your decisions in an advance health care directive.
- Find out about a do-not-resuscitate (DNR) order.
- Ask someone to be your health care agent or proxy. Be sure this person knows your wishes and if you make any changes in your health care choices.
As your life or health changes, you may also change your health care decisions. You can change or cancel an advanced care directive at any time.
Making the decision for a loved one
You may serve as a health care agent or proxy for someone else. In this role you may have to make the decision to start or remove life support machines. It is a very hard decision to make.
If you need to make a decision about stopping treatment for a loved one:
- Talk to your loved one's doctor.
- Review the goals of your loved one's medical care.
- Weigh the benefits and burdens of treatments on your loved one's health.
- Think about your loved one's wishes and values.
- Seek advice from other health care professionals, such as a social worker.
- Seek advice from other family members.
Rakel RE, Strach EM. Care of the dying patient. Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 5.
Winkler EC, Hiddemann W, Marckmann G. Ethical assessment of life-prolonging treatment. Lancet Oncol. 2011;12:720-722.
Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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