If, after carefully reviewing a patient's medical condition and progress, the patient (or Substitute Decision Maker) and the medical team agree that further treatment is not in the patient's best interest, a decision may be made to put limits on the treatment offered.
The decision to limit the treatment is individualized. For example, a decision may be made to continue to provide maximum medical support (including medications, ventilator therapy and dialysis), but to not intervene if the patient's heart stops beating (cardiac arrest).
If the patient is not responding to life-support treatment, and is believed to have an irreversible disease, a decision may be made between the family and health care team to withhold any additional life-support. For example, we may continue with the current level of medication and breathing support, but decide not to add any new treatments.
If death or a very poor quality of life is expected to the be the outcome of the illness, a decision may be made to stop any new treatments and to actively stop the life-support measures that are currently in place. When a decision is made to withdraw life-support therapy, death often occurs within a short period of time.
All decisions to limit treatment are made following careful consideration of the patients medical condition and following discussions with the patient or family. If a decision is made to withdraw or withhold further treatment, the team will meet with the family to discuss how the family would like to say goodbye. The comfort of the patient is always the priority.