by Nancy S. Jecker and Lawrence J. Schneiderman

About the authors: Nancy S. Jecker is a professor in the department of medical history and ethics at the University of Washington School of Medicine in Seattle. Lawrence J. Schneiderman is a professor of community and family medicine at the University of California School of Medicine in San Diego.

Physicians and other health professionals sometimes find themselves continuing aggressive medical procedures well beyond the point at which such measures would be useful. The impetus for this may come from a variety of sources. Perhaps the patient, fearful of death, desperately seeks every conceivable way to avoid it. Alternatively, a family member or loved one may implore the health care team to “do everything possible” and “spare no expense” when a patient is unconscious or...