Critically ill patients admitted to the Intensive Care Unit (ICU) have a high chance of dying from their illness. As a result, doctors discuss the matter of withdrawing or withholding treatment on a regular basis on the ICU. These decisions often incorporate the controversial ‘Do not attempt resuscitation’ (DNAR) orders. The DNAR orders are made by the treating physician after discussion with the patient if they are mentally able to make such a decision, and/or the patient’s family.

Guidance from the British Medical Association and General Medical Council presents the decision to withdraw or withhold treatment as a ‘clinical’ one. The doctor has to consider what is in the patient’s ‘best interests’. However, recent high-profile cases have challenged this guidance, and suggested that patients and their families should have more input into decisions related to withholding or withdrawing treatment. It would therefore be possible for a patient or their family to demand treatment that doctors may feel is not in the patient’s best ‘clinical’ interests.

This project aims to examine the ethical and legal issues arising in end of life decision-making in the Intensive Care Unit, with particular focus on DNAR decisions.