Faculty and Staff Publications
Language
English
Publication Date
6-1-2023
Journal
The American Journal of Bioethics
DOI
10.1080/15265161.2022.2075959
PMID
35616323
Abstract
Extracorporeal membrane oxygenation (ECMO) is typically viewed as a time-limited intervention-a bridge to recovery or transplant-not a destination therapy. However, some patients with decision-making capacity request continued ECMO support despite a poor prognosis for recovery and lack of viability as a transplant candidate. In response, critical care teams have asked for guidance regarding the ethical permissibility of unilateral withdrawal over the objections of a capacitated patient. In this article, we evaluate several ethical arguments that have been made in favor of withdrawal, including distributive justice, quality of life, patients' rights, professional integrity, and the Equivalence Thesis. We find that existing justifications for unilateral withdrawal of ECMO support in capacitated patients are problematic, which leads us to conclude that either: (1) additional ethical arguments are necessary to defend this approach or (2) the claim that it is not appropriate to use ECMO as a destination therapy should be questioned.
Keywords
Humans, Extracorporeal Membrane Oxygenation, Quality of Life, Critical Care, Patients, Dissent and Disputes, Decision-making, end of life issues, futility, moral theory, professional ethics
Published Open-Access
yes
Recommended Citation
Childress, Andrew; Bibler, Trevor; Moore, Bryanna; et al., "From Bridge to Destination? Ethical Considerations Related to Withdrawal of ECMO Support over the Objections of Capacitated Patients" (2023). Faculty and Staff Publications. 32.
https://digitalcommons.library.tmc.edu/ethics_pub/32