Clinical decisions to limit treatment

A case of a patient with gastrointestinal hemorrhage raises the question of limiting medical treatment. We analyze four reasons to limit treatment: Treatment is futile, the patient refuses treatment, the costs of treatment seem excessive, and the quality of life is judged unacceptable. For cases in which treatment is to be limited, we offer practical suggestions for compassionate and appropriate terminal care.

Ethical decisions in the care of a patient terminally ill with metastatic cancer

A case of a patient with metastatic cancer raises the issues of patient refusal of treatment, euthanasia, and unintended side effects of therapy. For each management dilemma, there are relevant ethical and legal considerations, justifications, and conclusions. In addition, psychological and social influences on the decision process tend to limit deliberation.