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September 20, 2006

Terminal Withdrawal of Life-Sustaining Supplemental Oxygen

Author Affiliations

Author Affiliations: Division of Pulmonary, Allergy, and Critical Care Medicine (Drs Halpern and Hansen-Flaschen), Center for Clinical Epidemiology and Biostatistics (Dr Halpern), and Center for Bioethics (Dr Halpern), University of Pennsylvania School of Medicine, Philadelphia.

JAMA. 2006;296(11):1397-1400. doi:10.1001/jama.296.11.1397

An influential report released in 1983 defined life-sustaining therapies as “all health care interventions that have the effect of increasing the life span of the patient.”1 This definition is highly inclusive: aspirin for stable coronary artery disease, intravenous antibiotics for osteomyelitis, and mechanical ventilation for respiratory failure all qualify. However, when considering withholding or withdrawing life-sustaining interventions, clinicians commonly refer to a more discrete group of therapies intended to forestall impending death by augmenting or replacing a vital bodily function. A hallmark of life-sustaining therapies, therefore, is that withholding or withdrawing them leads to physiologic decompensation foreseeably to cardiac arrest.

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