• Charles L Sprung, Fathima Paruk, Niranjan Kissoon, Christiane S Hartog, Jeffrey Lipman, Bin Du, Andrew Argent, R Eric Hodgson, Bertrand Guidet, A B Johan Groeneveld, and Charles Feldman.
• Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel. Electronic address: charless@ekmd.huji.ac.il.
• J Crit Care. 2014 Dec 1;29(6):890-5.

IntroductionWithholding life-sustaining treatments (WHLST) and withdrawing life-sustaining treatments (WDLST) occur in most intensive care units (ICUs) around the world to varying degrees.MethodsSpeakers from invited faculty of the World Federation of Societies of Intensive and Critical Care Medicine Congress in 2013 with an interest in ethics were approached to participate in an ethics round table. Participants were asked if they agreed with the statement "There is no moral difference between withholding and withdrawing a mechanical ventilator." Differences between WHLST and WDLST were discussed. Official statements relating to WHLST and WDLST from intensive care societies, professional bodies, and government statements were sourced, documented, and compared.ResultsSixteen respondents stated that there was no moral difference between withholding or withdrawing a mechanical ventilator, 2 were neutral, and 4 stated that there was a difference. Most ethicists and medical organizations state that there is no moral difference between WHLST and WDLST. A review of guidelines noted that all but 1 of 29 considered WHLST and WDLST as ethically or legally equivalent.ConclusionsMost respondents, practicing intensivists, stated that there is no difference between WHLST and WDLST, supporting most ethicists and professional organizations. A minority of physicians still do not accept their equivalency.Copyright © 2014 Elsevier Inc. All rights reserved.

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