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Type: Journal article
Title: The window of opportunity for treatment withdrawal
Author: Wilkinson, D.
Citation: Archives of Pediatrics & Adolescent Medicine, 2011; 165(3):211-215
Publisher: Amer Medical Assoc
Issue Date: 2011
ISSN: 1072-4710
Statement of
Dominic Wilkinson
Abstract: Physicians sometimes refer to a “window of opportunity” for withdrawing life-sustaining treatment in patients with acute severe brain injury. There is a period of critical illness and physiological instability when treatment withdrawal is likely to be followed by death but prognosis is uncertain. If decisions are delayed, greater prognostic certainty can be achieved, but with the risk that the patient is no longer dependent on life support and survives with very severe disability. In this article I draw on the example of birth asphyxia and highlight the role that the window of opportunity sometimes plays in decisions about life-sustaining treatment in intensive care. I outline the potential arguments in favor of and against taking the window into account. I argue that it is, at least sometimes, ethical and appropriate for physicians and parents to be influenced by the window of opportunity in their decisions about life-sustaining treatment.
Keywords: Humans; Hypoxia-Ischemia, Brain; Prognosis; Respiration, Artificial; Critical Care; Withholding Treatment; Uncertainty; Parents; Decision Making; Quality of Life; Infant, Newborn; Double Effect Principle
Rights: ©2011 American Medical Association.
RMID: 0020110441
DOI: 10.1001/archpediatrics.2011.4
Published version:
Appears in Collections:Obstetrics and Gynaecology publications

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