Stopping Life-Support Treatment

In the area of end of life (whether to continue or stop life support), multiple court decisions seem to favour the family side. In the case of baby K who was born with anenchephaly and ventilated, doctor's attempt to stop the treatment was met with judgment against them by 2 courts in US. The mother of baby K argue that in her deep moral/religious belief that ventilator treatment has been keeping baby K alive (search: physiological futility andalthough she understood that it will not cure the anomaly, every life, for her was precious (search: normative futility). There wasn't an issue about funding as the treatment was funded by insurance.

After the case, bioethicist came up with 5 conditions in which, if fulfilled, physician has duty to continue treatment:
1. in the context of ongoing doctor-patient relationship
2. the technology can preserve life
3. No competent collegue is willing to take over the patient's care
4. equitable funding - the care must be paid for privately
5. No other patient is put in jeopardy

In a contrary case whereby family wants to stop the treatment, but the doctor refused - as in the case of Karen Quinlan in 1975, which she overdosed some medication/drugs suffered massive brain damage. Doctor refused to stop treatment as he believed it was a medical duty to prolong life. The court sided with the family and commented that the family wish ought to be honoured. I do think that if the case happen today, the doctor would probably sided with family decision in the case of irreversible brain damage.

In deciding to stop medical treatment, there are 4 important issue to consider:
1.Active (eg:lethal injection) vs passive euthanasia (overseeing patients death). Passive euthanasia is widely considered acceptable in cases where the treatment, in doctors judgement, is futile.
2. Intention. Though different actions may produce similar outcome, a doctor's intention should not be to kill the patients/fasten the death.
3. Withholding vs withdrawing treatment. Although it is more difficult to stop treatment once it is instituted, generally, ethicist consider them as quite similar from moral prespective.
4. Ordinary vs extraordinary treatment. Ordinary treatment is considered when the treatment bring more benefit than risk, while extraordinary treatment is when benefit is not greater than harm.

My take on this is that, if there is a dispute with family members regarding stopping treatment, it will be wise to discuss this matter maturely, instead of making unilateral paternalistic decision.