Doctors May End Life Support, Lung Group Says : Health: Under the new policy, no consent is needed if a physician believes such treatments are futile.

A physician may withhold or withdraw life-sustaining medical treatment from a critically ill patient without his or his family’s consent if the physician believes that such measures are futile, the American Lung Assn. announced Monday.

“What we’re trying to say is that a patient or his surrogate does not have the right to require a therapy that will do no good,” said Dr. Paul N. Lanken, part of a 19-member American Lung Assn. task force of doctors, lawyers and nurses established to study the controversial issue of withholding and withdrawing life support. “Good medicine is not just keeping a person on a ventilator forever but to do good.”

Lanken, medical director of the intensive-care unit at the Hospital of the University of Pennsylvania, made his statements Monday during a press conference at the society’s 1991 International Conference at the Anaheim Convention Center. The American Lung Assn.’s medical section--the American Thoracic Society (ATS)--released the results of a national survey of its member physicians who practice pulmonary and critical-care medicine. The ATS also issued new physician guidelines on when to withhold or withdraw life support.

The survey of 900 physicians around the country found that 90% of those who work with critically ill adults have assisted in the withdrawal of a ventilator at some point during their careers. Half of the respondents had done so three or more times, the survey found. The survey addressed only situations concerning adult patients.

“I think the public and practicing physicians have come a long way in accepting that not all illnesses can be treated and death is not always something to be fought off entirely,” Lanken said.

About 2% of those surveyed said they had ceased life-sustaining measures against the wishes of the patient and his family, according to the task force.

“There can come a point when treatment becomes not only pointless but it may not be the best thing for the patient or the physician,” said Lawrence J. Nelson, another task force member who is a San Francisco attorney and bioethics consultant. “This occurs particularly with an elderly patient when the family gets together and says ‘Don’t let Mother die, do everything.’ ”

Meanwhile, the survey found that a third of respondents had refused at least once to take a patient off a ventilator at the family’s request because they thought the patient had a reasonable chance of recovering from his or her illness.

In announcing the survey results, task force members issued a policy statement that they said would provide general guidelines for doctors who treat critically ill adults. The policy states that “an adult patient who has the capacity to make decisions and is appropriately informed has the right to forgo all forms of medical therapy including life-sustaining therapy; an adult patient who no longer has the capacity to make decisions should continue to have the right to refuse all forms of medical therapy, however this right must be exercised on the patient’s behalf by an appropriate surrogate; a life-sustaining intervention may be withheld or withdrawn from a patient without the consent of the patient or surrogate if the intervention is judged to be futile.”

Previously, the American Lung Assn. had no such stated guidelines addressing the issue of withholding life-sustaining treatments. This official statement will be published in the American Lung Assn. journal later this year, task force members said.