Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
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.)
Workman S. Shared Decision Making About Withdrawing Treatment. JAMA. 2003;289(8):981. doi:10.1001/jama.289.8.981a