Differentiate between withholding and withdrawing life-sustaining treatment with regard to patient autonomy and legal standing.

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Honoring patient autonomy means decisions about life-sustaining treatment should reflect the patient’s own values and preferences, whether stated in advance directives or given by a surrogate. Withholding life-sustaining treatment—deciding not to start a therapy that could prolong life—and withdrawing life-sustaining treatment—stopping a therapy that is already ongoing—are ethical and legal ways to honor those preferences. There is no obligation to continue a treatment the patient would choose to decline. Both actions are permissible when they align with the patient’s wishes, with clear communication, informed consent, and proper documentation such as advance directives or POLST/physician orders. If the patient lacks capacity, surrogates use substituted judgment or best interests to guide the decision, still aiming to honor the patient’s values. The key point is that autonomy governs the choice, and the law generally supports both withholding and withdrawing as valid expressions of that autonomy.