Biomaterial Database

Stroke medicine-ethical and legal considerations. 2002

Stephen J Louw, and Jeffrey A Keeble

Level 6, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK. Stephen.Louw@tfh.nuth.northy.nhs.uk

In this short paper we set out to demonstrate common ground between Medical Ethics and Jurisprudence. We delineate the scope of the debate entailing juristic and medical ethical issues in stroke medicine. The article refers to joint legal and ethical issues pertaining to withholding and withdrawing life-sustaining treatment and advance directives. A key concern is that certain essential clinical prognostic questions require to be evaluated before any justifiable discussion about their ethical implications can ensue. The pre-eminence of the principle of autonomy in medical ethics and jurisprudence is emphasised throughout the paper.

UI	MeSH Term	Description	Entries
D004992	Ethics, Medical	The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families.	Medical Ethics
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016223	Advance Directives	Declarations by patients, made in advance of a situation in which they may be incompetent to decide about their own care, stating their treatment preferences or authorizing a third party to make decisions for them. (Bioethics Thesaurus)	Health Care Power of Attorney,Medical Power of Attorney,Healthcare Power of Attorney,Psychiatric Wills,Ulysses Contracts,Advance Directive,Attorney Healthcare Power,Attorney Medical Power,Contract, Ulysses,Contracts, Ulysses,Directive, Advance,Directives, Advance,Psychiatric Will,Ulysses Contract,Will, Psychiatric,Wills, Psychiatric
D020521	Stroke	A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)	Apoplexy,Cerebral Stroke,Cerebrovascular Accident,Cerebrovascular Apoplexy,Vascular Accident, Brain,CVA (Cerebrovascular Accident),Cerebrovascular Accident, Acute,Cerebrovascular Stroke,Stroke, Acute,Acute Cerebrovascular Accident,Acute Cerebrovascular Accidents,Acute Stroke,Acute Strokes,Apoplexy, Cerebrovascular,Brain Vascular Accident,Brain Vascular Accidents,CVAs (Cerebrovascular Accident),Cerebral Strokes,Cerebrovascular Accidents,Cerebrovascular Accidents, Acute,Cerebrovascular Strokes,Stroke, Cerebral,Stroke, Cerebrovascular,Strokes,Strokes, Acute,Strokes, Cerebral,Strokes, Cerebrovascular,Vascular Accidents, Brain
D028761	Withholding Treatment	Withholding or withdrawal of a particular treatment or treatments, often (but not necessarily) life-prolonging treatment, from a patient or from a research subject as part of a research protocol. The concept is differentiated from REFUSAL TO TREAT, where the emphasis is on the health professional's or health facility's refusal to treat a patient or group of patients when the patient or the patient's representative requests treatment. Withholding of life-prolonging treatment is usually indexed only with EUTHANASIA, PASSIVE, unless the distinction between withholding and withdrawing treatment, or the issue of withholding palliative rather than curative treatment, is discussed.	Withdrawing Care,Cessation of Treatment,Withdrawing Treatment,Care, Withdrawing,Treatment Cessation,Treatment Cessations,Treatment, Withdrawing,Treatment, Withholding,Treatments, Withdrawing,Treatments, Withholding,Withdrawing Treatments,Withholding Treatments