End of Line Decision Making - Dr. Jovito R. Salonga Center for Law

Property of Silliman College of Law
Title
:
End of Line Decision Making: legal issues concerning Do Not
Resuscitate (DNR) Orders and surrogate decision making with respect
to foregoing life sustaining treatment.
Author
:
Leoni Mae Rubi L. Tam
Program
:
Juris Doctor
Copyright
:
March 13, 2015
Abstract
:
It is a fact of life that death is inevitable. Yet, in Philippine
setting it is often regarded as a grim reality where discussions about
death are done in hushed tones. Nevertheless, it is one wherein each
individual will have to face with through life, though in varied ways.
The advent of modern healthcare technology has paved the way
for the prolongation of human life. Corollary to this development, the
use of measures to limit care, such as Do-Not-Resuscitate (DNR)
orders or terminal withholding or withdrawal of support proliferated
and because life support is often extended to critically ill patients, legal
questions concerning the withholding or withdrawal of such support
comes frequently in end-of-life care.
This paper seeks to examine the legal issues involving
withholding of life support to critically ill patients. It tackles on the
personal moment of a patient’s life and their respective families or
surrogates as they are confronted with a situation, which they have to
choose whether to let the patient live or die.
Discussed in the first and second part are the evolving concepts
of death in the society, legal opinions regarding withholding or
withdrawing support, the use of advance directives in such patients,
nature of physician-patient relationship especially during end-of-life
care, the importance of informed consent and the capacity of a
surrogate decision maker to make decisions for incapacitated and
incompetent patients in withholding treatment.
While contained in the third and fourth part of this paper is the right
of life of an individual, the state’s interest in the individual’s life visà-vis the right of an individual to refuse treatment and selfdetermination, enforceability of DNR orders and written directive
under Philippine Law, as well as a legal framework on how to go about
Property of Silliman College of Law
DNR orders in Philippine setting and the adoption of a patient’s bill
of rights.