What to do when relatives ask the doctor to stop treatment of a critically ill patient?

QUESTION—What should the hospital / doctors do when the attendants of an unconscious patient with tracheostomy tube, IV lines, Ryle’s tube and indwelling catheter demand that all these be removed at their own risk and responsibility?

1—A doctor’s duty is to save, not to take life. Taking life is homicide. Removal of these gadgets will be tantamount to an attempt to take life which also is a criminal act.

2—A doctor is supposed to give or withhold or withdraw or change treatment as per principles of medicine and not as per the orders of a layman or even the patient himself. A doctor who acts otherwise will be guilty of misconduct / negligence.

3—If the act of removing the appliances is done by the doctors or the hospital staff, the risk and responsibility are to be faced by the person doing the act. The relatives cannot be made responsible for the acts of the hospital staff.

4—Even if the relatives make a written request to the hospital to withdraw treatment / appliances, such written request has no meaning in law. Consent for treatment or its stoppage has to come from the patient or his authorised representative.

5—If the authorised representative makes a written request to the doctors to stop treatment when the result of stopping treatment might result in death, the doctors should not act upon the request because euthanasia is not allowed by law. In such a situation, the hospital should contact its advocate for necessary guidance.

---M C Gupta
MBBS & MD (Medicine), AIIMS;
LL.B. (Delhi); LL.M. (Kurukshetra)
Fellow: National Foundation of Clinical Forensic Medicine
Ex-Additional Professor, AIIMS
Ex-Professor and Dean, NIHFW
Practicing advocate

Please add in para 5 ,inform police for such request made by relatives.Admiral[Dr] V K Singh