Case Report 4: Withhold & Withdraw of life support system
A forty-five -year old terminally gastric cancer woman can not drink and eat because of total G-I obstruction. The relatives requested TPN(total parenteral nutrition) through CVP line for the patient. After two months, the patinet asked to discontinue TPN since she was too tired and ready to die. However, her husband thought the patient would starve and thirst to death by this way.
Discussion: On hospice palliative care ethics, could doctor withdraw TPN? Or, could doctor withhold TPN two months ago in this case?
5.Euthanasia vs. Natural Death:
People in Taiwan often mistake "Natural Death" for "Passive Euthanasia". The definition of 'Active Euthanasia' is an action performed within a medical setting which is done with the intention of terminating a human life. The definition of "Passive Euthanasia" is "the withdrawal or withholding of some necessary treatment for the maintenance of human life." It can also be described as" a decision not to prolong life" or "a non-treatment decision". (British Medical Association, 1988). The former involves an act or intervention which causes death and the latter involves the cessation of life-prolonging treatment.
The "Natural Death" is that "patients who express the wish that they will be allowed to die a reasonably natural death without being subject to an intrusive and futile battery of medical interventions which only can prolong dying process." (British Medical Association, 1988)
The patients' relatives and hospice staff in Taiwan sometime feel that as long as they do everything that could be expected they cannot
