ArticleThe American journal of bioethics : AJOB2019
Withdrawal Aversion and the Equivalence Test.
Article in The American journal of bioethics : AJOB, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed.
- Decision-making for older adults with advanced heart disease: a framework for balancing benefit versus futility.European heart journal · 2026Review
- Nuanced Public Support for Rationing Treatments by Withdrawing and Withholding Due to Negative Reimbursement Decisions.Journal of bioethical inquiry · 2026Article
- Advance care planning in Japan: Gaps between policy, ethical understanding, and its translation into clinical practice.Palliative care and social practice · 2026Article
- Healthcare professionals' experiences of participating in withdrawing life-sustaining treatment decisions in a Chinese intensive care unit: a qualitative study.BMC medical ethics · 2025Article
- Paediatric end-of-life care and cardiopulmonary resuscitation.Paediatrics & child health · 2025Article
- A network analysis of timing and conditions present at time of death for periviable infants (22+0-23+6 weeks) admitted to neonatal intensive care after receiving survival-focused care at birth.Frontiers in pediatrics · 2025Article
- Legal provisions on medical aid in dying encode moral intuition.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Ethics in humanitarian settings-relevance and consequences for dialysis and kidney care.Clinical kidney journal · 2024Review
- Limitation of life sustaining therapy in disorders of consciousness: ethics and practice.Brain : a journal of neurology · 2024Review
- Differences in directives to limit treatment and discontinue mechanical ventilation between elderly and very elderly patients: a substudy of a multinational observational study.Intensive care medicine · 2023Observational
- End of life care in the setting of extreme prematurity - practical challenges and ethical controversies.Seminars in fetal & neonatal medicine · 2023Review
- Could palliative sedation be seen as unnamed euthanasia?: a survey among healthcare professionals in oncology.BMC palliative care · 2023Article
- Citizen attitudes to non-treatment decision making: a Norwegian survey.BMC medical ethics · 2023Article
- Biases in bioethics: a narrative review.BMC medical ethics · 2023Review
- "Death as the One Great Certainty": ethical implications of children with irreversible cardiorespiratory failure and dependence on extracorporeal membrane oxygenation.Frontiers in pediatrics · 2023Article
- Withdrawing or withholding treatments in health care rationing: an interview study on ethical views and implications.BMC medical ethics · 2022Article
- Report of the Lancet Commission on the Value of Death: bringing death back into life.Lancet (London, England) · 2022Review
- Singapore Neonatal Resuscitation Guidelines 2021.Singapore medical journal · 2021Article
- Coronavirus Disease 2019: Withdrawing Mechanical Ventilation to Reallocate Life Support Under Crisis Standards of Care-Nonequivalence of the Equivalence Thesis.Critical care medicine · 2020Review
- Covid-19: Ethical Challenges for Nurses.The Hastings Center report · 2020Article
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Authors and funding
3 authors.
Funding
Abstract
If a doctor is trying to decide whether or not to provide a medical treatment, does it matter ethically whether that treatment has already been started? Health professionals sometimes find it harder to stop a treatment (withdraw) than to refrain from starting the treatment (withhold). But does that feeling correspond to an ethical difference? In this article, we defend equivalence-the view that withholding and withdrawal of treatment are ethically equivalent when all other factors are equal. We argue that preference for withholding over withdrawal could represent a form of cognitive bias-withdrawal aversion. Nevertheless, we consider whether there could be circumstances in which there is a moral difference. We identify four examples of conditional nonequivalence. Finally, we reflect on the moral significance of diverging intuitions and the implications for policy. We propose a set of practical strategies for helping to reduce bias in end-of-life decision making, including the equivalence test.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.