Two-physician certification in end-of-life decision making

Members of the care team repeatedly telephoned and sent text messages to the designated medical power of attorney and sole contact listed in the patient's electronic medical record; however, there was no response. The New York State Task Force on Life and the Law report When others must choose: deciding for patients without capacity presents guidelines for the use of a modified version of two-physician certification at the end of life: A decision to forgo life-sustaining treatment should be authorised if (1) the attending physician recommends the withdrawal or withholding of treatment, in consultation with other health-care personnel directly involved in the patient's care; (2) a second physician concurs in the recommendation; and (3) the bioethics review committee approves the recommendation. AH declares consulting fees from Genetech and Jazz Pharmaceuticals; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from The American Journal of Managed Care; support for attending meetings or travel from AbbVie and The American Journal of Managed Care; participation on a data safety monitoring board or advisory board with GSK, AbbVie, and AstraZeneca; receipt of equipment, materials, drugs, medical writing, gifts, or other services from Genentech; and other financial or non-financial interests (spousal employment) with Real Chemistry.