FORGOING LIFE-SUSTAINING TREATMENT IN AN ISRAELI ICU

Objective: To determine whether physicians in Israel withhold and/or w ithdraw life-sustaining treatments, Design: A prospective, descriptive study of consecutively admitted patients. Patients were prospectively evaluated for diagnoses, types and reasons for forgoing life-sustaini ng treatments, mortality and times from forgoing therapy until mortali ty. Setting: A general intensive care unit of a university hospital in Israel. Results: Forgoing life-sustaining treatment occurred in 52 (1 3.5 %) of 385 patients admitted and 5 (1 %) had cardiopulmonary resusc itation. Withholding therapy occurred in 48 patients. Four patients wi th brain death had all treatments withdrawn. No patient had antibiotic s, nutrition or fluids withheld or withdrawn. Time from forgoing thera py until death was 2.9 +/- 0.6 days. Thirty-one of 48 (65 %) patients who had therapy withheld died within 48 h. Conclusions: Withholding li fe-prolonging treatments is common in an Israeli intensive care unit w hereas withdrawing therapy is limited to brain dead patients. Terminal patients die soon after withholding, even if the therapy is not withd rawn. Withholding treatments should be an option for patients and prof essionals who object to withdrawing therapies.