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Hospital Policy on Appropriate Use of Life-sustaining Treatment
Critical Care Medicine (2001)
  • Peter A. Singer, University of Toronto
  • Geoff Barker, University of Toronto
  • Kerry W. Bowman
  • Christine Harrison, University of Toronto
  • Philip Kernerman, University of Toronto
  • Judy Kopelow
  • Neil Lazar, University of Toronto
  • Charles Weijer, Dalhousie University
  • Stephen Workman, Dalhousie University

OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate.

DESIGN: Case study.

SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining Treatment.

PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal scholar, a health administration expert, a social worker, and a hospital public relations professional.


MEASUREMENTS AND MAIN RESULTS: Our specific lessons learned include a) a policy focus on process; b) use of a negotiation and mediation model, rather than a hospital ethics committee model, for this process; and c) the policy development process is itself a negotiation, so we recommend equal involvement of interested groups including patients, families, and the public.

CONCLUSIONS: This article describes the key issues faced by the Task Force while developing its policy. It will provide a useful starting point for other groups developing policy on appropriate use of life-sustaining treatment.

  • Interprofessional Relations,
  • Life Support Care,
  • Medical Futility
Publication Date
January, 2001
Publisher Statement
Dr. Charles Weijer is currently a faculty member at The University of Western Ontario.
Citation Information
Peter A. Singer, Geoff Barker, Kerry W. Bowman, Christine Harrison, et al.. "Hospital Policy on Appropriate Use of Life-sustaining Treatment" Critical Care Medicine Vol. 29 Iss. 1 (2001)
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