Important to develop guidelines
As a group of concerned medical practitioners, the Hong Kong Society of Critical Care Medicine, welcomes the attention the Medical Council and the public is paying to the important issue of the dying process of patients in Hong Kong.
We support the views expressed in the letter headlined, 'Withdrawal of life support not 'euthanasia' ', co-signed by the Hong Kong Society of Palliative Medicine and other organisations (South China Morning Post, January 20).
We would like to stress the distinction between euthanasia (passive or otherwise) and withholding and withdrawal of therapy. Euthanasia is defined as 'direct intentional killing of a person as part of the medical care offered'. Our understanding is that euthanasia is illegal in most parts of the world, including Hong Kong. Intensive care professionals in Hong Kong do not practise euthanasia. The practice of withholding and withdrawing life support is, however, common. The increasing incidence of withholding and withdrawing therapy is due to the existence of technology that has made it possible to continue organ support long after meaningful recovery is not possible. It is to avoid the cruel consequences of continuous, hopeless life support that withholding and withdrawing life support have become necessary.
Withholding or withdrawing life support would not be done with the intention of killing the patient. It is instead the choosing between different ways of dying.
The intention of withholding or withdrawing life support is to help the dying to achieve a peaceful and dignified death, so that the process of suffering and death is not unnecessarily prolonged. This is an appropriate and accepted practice in most parts of the world, including Great Britain, continental Europe, Australasia and the US.
As intensive care physicians, every day we make important decisions about provision and withdrawal of life support. We fully support the Medical Council in developing guidelines on issues such as withholding and withdrawal of therapy. We believe that the Medical Council guidelines should reflect the values of the society that we all serve.
HONG KONG SOCIETY OF CRITICAL CARE MEDICINE