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Scott D. Halpern, MD, PhD, MBioethics; John Hansen-Flaschen, MD

JAMA. 2006;296:1397-1400.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

An influential report released in 1983 defined life-sustaining therapies as "all health care interventions that have the effect of increasing the life span of the patient."¹ This definition is highly inclusive: aspirin for stable coronary artery disease, intravenous antibiotics for osteomyelitis, and mechanical ventilation for respiratory failure all qualify. However, when considering withholding or withdrawing life-sustaining interventions, clinicians commonly refer to a more discrete group of therapies intended to forestall impending death by augmenting or replacing a vital bodily function. A hallmark of life-sustaining therapies, therefore, is that withholding or withdrawing them leads to physiologic decompensation foreseeably to cardiac arrest.

Supplemental oxygen has not commonly been considered a life-sustaining therapy. Yet it clearly serves this purpose for spontaneously breathing patients in whom pulmonary gas exchange is so impaired that the needs of vital organs cannot be met with ambient air alone. . . . [Full Text of this Article]

Concerns About Balancing the Burdens and Benefits of Supplemental Oxygen

Author Affiliations: Division of Pulmonary, Allergy, and Critical Care Medicine (Drs Halpern and Hansen-Flaschen), Center for Clinical Epidemiology and Biostatistics (Dr Halpern), and Center for Bioethics (Dr Halpern), University of Pennsylvania School of Medicine, Philadelphia.