End-of-life care: Who decides when to pull the plug?

The notion that a patient or family member can require any type of care, regardless of its propriety, has long been disavowed by the American Medical Association. The AMA's Code of Medical Ethics has recognized this principle since at least 1994, when it published an opinion that states: "Physicians are not ethically obligated to deliver care that, in their best professional judgment, will not have a reasonable chance of benefitting their patients. Patients should not be given treatments simply because they demand them." In the same opinion, however, the AMA also found that "Denial of treatment should be justified by reliance on openly stated ethical principles and acceptable standards of care . . . not on the concept of 'futility,' which cannot be meaningfully defined." Modern Medicine