Surgical Risks and Advance Directives
Lederer, Daniel H.
Brock, Dan W.
Hastings Center Report. 1987 Aug; 17(4): 18-19.
An elderly patient with chronic lung disease is reluctant to undergo hip surgery because she fears possible ventilator dependency and coma. She will consent to the operation if her surgeon will agree to be legally obligated to remove the ventilator after a specified time. Lederer, a physician, objects to this application of patient autonomy because it might place the surgeon in legal jeopardy of collusion in suicide and would undermine the principles of nonmaleficence and mutual trust. Brock, a philosophy professor, supports the patient's desire for giving advance instructions about her care; allays the surgeon's legal concerns; and rejects any moral distinction between initiating and withdrawing treatment. He suggests modifications in the advance directive agreement that would be acceptable to the patient yet preserve the physician's responsibility to exercise his professional judgment without violating his moral or professional integrity. (KIE abstract)
Advance Directives; Aged; Allowing to Die; Autonomy; Case Studies; Chronically Ill; Coma; Consent; Disease; Legal Aspects; Life; Moral Policy; Nonmaleficence; Paternalism; Patient Care; Persistent Vegetative State; Philosophy; Physician Patient Relationship; Physicians; Prognosis; Prolongation of Life; Quality of Life; Right to Die; Suicide; Surgery; Technical Expertise; Treatment Refusal; Trust; Withholding Treatment;
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