Ravivõtmist

Ravivõtmist is a term used in Estonian to describe the act of withdrawing medical treatment that has been started for a patient. It covers the cessation of therapies such as medications, procedures, or life-sustaining interventions, as well as the discontinuation of ongoing treatment regimens when it is deemed appropriate. The term is distinct from non-adherence or self-medication; it refers to a deliberate decision by the patient or their proxy to stop treatment.

Decision-making in ravivõtmise contexts centers on respect for autonomy and informed consent. If the patient has decision-making capacity, their wishes should guide the process. When capacity is lacking, a legally authorized proxy or an advance directive may be used. Healthcare providers should communicate clearly about prognosis, the potential benefits and burdens of continued treatment, available alternatives (including palliative or comfort-focused care), and possible consequences of withdrawal.

The withdrawal process typically involves planning with a multidisciplinary team, careful documentation in the patient’s medical records, and the implementation of measures to manage symptoms and minimize suffering. In end-of-life care or when treatment is considered medically futile, ravivõtmist is often discussed as part of a broader care plan.

Ethical and legal considerations emphasize autonomy, beneficence, and non-maleficence. In many jurisdictions, patients have the right to refuse treatment, provided they have capacity and the decision complies with legal frameworks. In contested or complex cases, ethics consultations or legal guidance may be sought.

Common challenges include difficult conversations, family disagreements, prognostic uncertainty, and concerns about prematurely withdrawing care. Effective communication, compassionate support, and adherence to professional standards are essential in navigating ravivõtmist.