Ann Acad Med Singap
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This paper examines the legal rights of a patient and his family in a situation where the patient's life is maintained by a life support system. It examines the duty and liability of a doctor who is of the view that the life-support should be terminated and, whether, in such situations the consent of the patient or his family or the Court is required.
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Despite many innovations in the management of hypoxic-ischaemic brain injury over the past 20 years, none has been proven to improve the outcome in patients. "Neuroresuscitation" with its emphasis on monitoring and control of intracranial pressure has not increased the number of neurologically intact survivors. New insights into the pathogenesis of hypoxic-ischaemic encephalopathy, particularly the role of calcium ions, excitatory amino acids and free-oxygen radicals, have led to potential treatment modalities which are now under experimental study but cannot as yet be recommended as standard therapy. At present, the cornerstone of management of hypoxic-ischaemic encephalopathy is still supportive care and careful maintenance of systemic homeostasis.