Autonomy (Physician)
The treating physician is under no ethical or legal obligation to offer, implement, or continue medically inappropriate (i.e., futile or non-beneficial) treatment, including life-sustaining treatments and CPR. Every intervention is a ‘trial of treatment’. Patients should not be encumbered with treatments that cannot be reasonably expected to achieve meaningful goals of care (such as return to pre-injury/illness status, discharge from the hospital to home, discharge to non-acute care). Should a patient’s life-sustaining management become futile in this sense, the treating or consulting physician — following a previously established ‘Protocol for Futile (Non-beneficial) Care Determination’ — may enter appropriate orders restricting or withdrawing life-sustaining treatments. At all times, pain relief and comfort measures should be provided.