For Them Rather Than by Them
Capron, Alexander Morgan
Hastings Center Report. 1993 Nov-Dec; 23(6): 30-31.
When we do not know what forms of life support patients want and for how long, should we presume that they want all available means to keep them alive? If not, under what circumstances should we presume the opposite? And to the extent that using (or not using) certain methods of life support are permissible but not obligatory, who ought to decide when to treat and when not to? With the dispersion of high-technology medicine around the world, the tension among autonomy, beneficence, and sanctity of life that occurs every day in hospitals spills over ever more frequently into courts and legislatures as well. In the United States, lawmakers have shown great enthusiasm over the past decade for advance directives; forty-seven states now have legislation authorizing instructional directives, such as living wills, and forty-eight have laws on proxy directives, such as durable powers of attorney for health care. Yet relatively little is known about directives' actual efficacy or about how to ensure that decisions made pursuant to them best serve the interests or the wishes of the people who execute them. Two recent events -- one in New Zealand and the other in Oregon -- mark a new direction in this area.
Advance Directives; Allowing to Die; Artificial Feeding; Autonomy; Beneficence; Consent; Decision Making; Dementia; Family Members; Forms; Health; Health Care; Hospitals; International Aspects; Judicial Action; Legal Aspects; Legal Liability; Legislation; Life; Living Wills; Laws; Liability; Medicine; Methods; Paternalism; Patients; Physicians; Proxy; Sanctity of Life; Technology; Third Party Consent; Ventilators; Withholding Treatment; Wills;