PT  - JOURNAL ARTICLE
AU  - M G Tweeddale
TI  - Grasping the nettle—what to do when patients withdraw their consent for treatment: (a clinical perspective on the case of Ms B)
AID  - 10.1136/jme.28.4.236
DP  - 2002 Aug 01
TA  - Journal of Medical Ethics
PG  - 236--237
VI  - 28
IP  - 4
4099  - http://jme.bmj.com/content/28/4/236.short
4100  - http://jme.bmj.com/content/28/4/236.full
SO  - J Med Ethics2002 Aug 01; 28
AB  - Withdrawal of active treatment is common in medical practice, especially in critical care medicine. Usually, however, it involves patients who are unable to take part in the decision making process. As the case of Ms B shows, doctors are sometimes reluctant to withdraw active treatment when the patient is awake and requesting such a course of action. In theory, having a competent patient should facilitate clinical decision making, so where does the problem arise? It is argued that latent medical paternalism may come to the surface when doctors are asked by patients to follow a course of action which is in conflict with their own perspective.