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September 20, 2000

Is It Ethical to Withdraw Low-Burden Interventions in Chronically Ill Patients?

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(11):1380-1382. doi:10.1001/jama.284.11.1378

To the Editor: Dr Pellegrino1 presented a clinically useful framework for ethically evaluating the decision to withdraw a life-sustaining medical treatment. However, the conclusion derived from its application for Reverend G fails logical analysis with specific regard to the futility of stopping a pacemaker. The analysis confused the question of stopping the pacemaker with ending a burdensome life. While the 2 issues are inextricably linked, Pellegrino specifically applied his algorithm to the pacemaker treatment, not the overlying dementia.

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