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Volume 349:2565-2567 December 25, 2003 Number 26
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Withdrawal of Mechanical Ventilation

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 by Drazen, J. M.
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 by Cook, D.
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To the Editor: In their report on the withdrawal of mechanical ventilation in anticipation of a patient's death, Cook et al. (Sept. 18 issue)1 state that their findings "suggest that the process of withdrawal of life support is attentive to patients' wishes." Strictly speaking, the study showed that the process is attentive to caregivers' perceptions of their patients' wishes. How were these perceptions formed?

Social scientists have long argued that end-of-life decision making and practices are shaped by caregivers' implicit moral understanding of what constitutes appropriate care.2 At least two studies show that many experts in the provision of life-support . . . [Full Text of this Article]




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