Safeguarding the unconscious patients’ overall benefit : towards a ‘consensus-building’ approach

Abstract

Clinical decision-making is a fundamental aspect in medical practice. Healthcare professionals, patients and their relatives are routinely involved in reviewing options for diagnostic studies and treatment. Though healthcare professionals get familiar and comfortable with the decision-making process, patients approaching the end of life as well as their relatives are usually unprepared to face the thorny ethical issues involved in such a complex process. With today's advancement in the field of biomedicine, biotechnology and pharmacology, patients approaching the end of their lives are offered highquality treatment and care. However, such advancement in end-of-life treatment raises ethical issues that are clinically complex and emotionally distressing. The classical medical-ethical question: 'what should we do in relation to what we can do?' assumes a novel dimension in today's development of knowledge and biotechnology which offer new possibilities to prolong the process of dying. These clinical advancements raise the issue concerning the ethical permissibility to withhold and withdraw life-sustaining treatment when the evidence of the benefits, burdens and risks of this treatment are not always clear-cut, and when there may be uncertainty about the clinical effects of a treatment.