Who Decides Who Decides?
Schneiderman, Lawrence J.
Kalmanson, Alvin G.
Archives of Internal Medicine. 1995 Apr 24; 155(8): 793-796.
We believe that in the case described herein, the patient's expressed wishes were appropriately honored by the physicians. However, since the patient's agent was constantly at the patient's bedside, it would have been an easy matter for a physician to arrange a joint interview of the patient to resolve the dispute. Only if the patient's requested treatment prolonged his life in a severely diminished state of awareness would it have been appropriate to turn to the patient's designated agent and accept that person's decision or (if the unconsciousness became irrevocable) take steps to withdraw the treatment on grounds of futility. In this case, the agent's views were supported by a diverse group including members of the family and friends. By their manifestations of attention and devotion, they seemed clearly to be the ones who were a close second to the patient in terms of bearing the consequences of any treatment decisions. Under these circumstances, in our view, it would be reasonable and appropriate for the physician to accept the agent's opinion without seeking help from an ethics committee or judgment from a court.
Advance Directives; Aids; Allowing to Die; Case Studies; Competence; Consent; Consultation; Decision Making; Directive Adherence; Dissent; Ethics; Friends; Futility; Guardians; Informed Consent; Legal Guardians; Life; Patients; Physicians; Prolongation of Life; Referral and Consultation; Resuscitation; Resuscitation Orders; Terminal Care; Third Party Consent; Uncertainty; Unconsciousness; Withholding Treatment;