Decision process

In addition to the medical indication and the patient's actual or presumed wishes, factors such as the patient's biological age, probable future quality of life, and general state of health, as well as the current situation and prognosis, should be taken into account when making the decision. The question of adequate redistribution of resources should not be crucial in withholding or withdrawing life-sustaining treatments in an individual case.

It is recommended that all medical personnel caring for the patient be included in the decision process; all their judgments must be respected and consensus should be sought. The opinions of proxies should also be integrated in the decision process without burdening these persons with codecision. The final decision has to be made by a physician; he or she will have to take the responsibility for the consequences.

Following the decision to withhold or withdraw a life-sustaining treatment, responsibility for continuation of patient care must be assumed by the whole medical team. After withholding or withdrawing life-support measures, comfort therapy (analgesia etc.) should be applied as required, even if such procedures shorten the patient's life. The patient and his or her family have a right to continuing and adequate human sympathy and respect.

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