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February 26, 2003

Shared Decision Making About Withdrawing Treatment

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(8):981. doi:10.1001/jama.289.8.981a

To the Editor: Drs Prendergast and Puntillo1 argued that families should be asked to share the burden of deciding to withdraw life-sustaining interventions in terminally ill patients. However, the authors do not describe exactly how such sharing is to be accomplished.

Physicians have limited choices when talking with family members about treatment withdrawal. They may model decision making on the process of informed consent for initiating treatment, thereby providing families with information and guidance and possibly advice.2 Decisional responsibility, however, clearly remains with family members. (In fact, the consent process can never give rise to demands for treatment since it is only the option of continuing treatment that is considered.)

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