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ETH-029: Process for Resolving Disputes About Treatment Decisions

Process for Resolving Disputes About Life-Sustaining Treatment Decisions: The Wisconsin Medical Society supports the following provisions in regard to disputes about life sustaining treatment decisions:

  1. Attending physicians and their patients should have an open and honest dialogue about what is the best treatment available to the patient as well as the goals, benefits, risks and potential outcomes of any prescribed treatment. These conversations should be had between physicians and patients at the beginning of treatment, and any potential problems or disputes addressed as early as possible.
  2. In matters relating to life-sustaining treatment physicians should inform their patients when life-sustaining treatment may no longer be desirable or feasible in the estimation of the attending physician. In such circumstances where a patient, or an individual who has legal authority to make health care decisions for the patient, disagrees with a physician’s decision to withdraw, withhold, or reduce life-sustaining treatment an ethics committee or other institutional resources should be consulted to determine a course of action. Physicians, patients and other relevant parties should be allowed to attend the ethics committee meeting.
  3. If either the physician or the patient choose not to accept the determination made by an ethics committee reasonable efforts should be made by the physician, or physician’s facility, to transfer the patient to another physician or facility. The patient would continue to receive all current life-sustaining treatment pending their transfer; however, if transfer is not possible, the physician is under no ethical obligation to continue providing life-sustaining treatment.
  4. Disagreements or discussions regarding the medical appropriateness and benefit of life-sustaining treatment should in no way reduce or impact the provision of medically appropriate interventions, including appropriate symptom management and palliative care.
  5. The Society encourages physicians to familiarize themselves with the AMA Principles of Medical Ethics 5.5, “Medically Ineffective Interventions.” (HOD, 0417)