Emedinews:Insights on Medicolegal Issues:Ordinary and extraordinary medical care

The Pope and Catholic teachings advocate a distinction between ordinary and extraordinary care, with ordinary care being mandatory, whereas extraordinary care may be withheld or withdrawn.*

One commentator explicated this distinction in the following way. According to him,

• Ordinary means of preserving life are all medicines, treatments, and operations, which offer a reasonable hope of benefit for the patient and which can be obtained and used without excessive expense, pain, or inconvenience…
• Extraordinary means of preserving life mean all medicines, treatments, and operations, which cannot be obtained without excessive expense, pain, or other inconvenience, or which, if used, would not offer reasonable hope of benefit.

Many ethicists and courts have concluded that this distinction is too vague and has "too many conflicting meanings" to be helpful in guiding surrogate decision makers and clinicians As one lawyer noted ordinary and extraordinary are "extremely fact–sensitive, relative terms…what is ordinary for one patient under particular circumstances may be extraordinary for the same patient under different circumstances, or for a different patient under the same circumstances". Thus, the ordinary/extraordinary distinction should not be used to justify decisions about stopping treatment.

*Pope Pius XII. The prolongation of life In: Ethics in medicine. Reiser SJ, Dyck AJ, Curran WJ (Eds), MIT Press, Cambridge 1997.