The pure subjective standard allows the surrogate to withhold life-sustaining treatment from an incompetent patient "when it is clear that the particular patient would have refused the treatment under the circumstances involved."
Can a patient refuse life-sustaining medical treatment?
Feb 14, 2022 · Under the Act, who has authority to be appointed the surrogate for a patient who lacks decisionmaking capacity? Under what circumstances may a surrogate refuse life-sustaining treatment? Under what circumstances may life-sustaining treatment be withheld or withdrawn from a patient who lacks decision-making capacity but does not have a surrogate?
What is the surrogate’s role in the evaluation of treatment?
A person is unavailable if (i) the person's existence is not known, (ii) the person has not been able to be contacted by telephone or mail, or (iii) the person lacks decisional capacity, refuses to accept the office of surrogate, or is unwilling to respond in a manner that indicates a choice among the treatment matters at issue.
When is a person unavailable as a surrogate?
Notably, after its passage, the HCSA was amended to allow a surrogate to make certain other medical decisions in addition to decisions regarding life-sustaining treatment. As to the former, the patient must lack decisional capacity, but no qualifying condition is required. 18. 755 ILL. COMP. STAT.ANN 40/20 (2009). 19.
What are the provisions of the Surrogacy Act?
Mar 11, 2014 · As straightforward as the foregoing analysis may seem, in real life it turns out to be very difficult to withhold or withdraw a life-sustaining treatment. Many health care providers believe that any omission of a life-sustaining treatment is tantamount to euthanasia or at least assistance in the patient’s suicide. And health professionals are not the only ones to reason in …
What criteria would you use to determine whether to terminate life-sustaining treatment?
When is it justifiable to discontinue life-sustaining treatments? If the patient has the ability to make decisions, fully understands the consequences of their decision, and states they no longer want a treatment, it is justifiable to withdraw the treatment.
Which legally allows parents to withhold life-sustaining treatment from a terminally ill child?
ADVANCE DIRECTIVES An advance directive is a general term that refers to one of two legal documents used to speak for the patient in the event that they cannot make decisions for themselves. Those two legal documents are 1) a living will or 2) the durable power of attorney.Apr 2, 2004
When should the decision to refuse lifesaving treatment be accepted?
This is most likely due to the uniqueness of each patient's scenario and the fact that DMC must be evaluated on a case-by-case basis. In general, if a patient with decision-making capacity refuses the recommended medical treatment, his or her refusal must be honored and accepted [7].
Can patients refuse a life supporting treatment that is keeping them alive?
Any person who is capable of making medical decisions for themselves may refuse life-sustaining and even life-saving treatments. They can do this even if their life will be shortened, and even if they are not terminally ill. An informed refusal of medical treatment should always be respected.
What is life sustaining treatment definition?
Life-sustaining treatment is any treatment that serves to prolong life without reversing the underlying medical condition. Life-sustaining treatment may include, but is not limited to, mechanical ventilation, renal dialysis, chemotherapy, antibiotics, and artificial nutrition and hydration.
Under what condition might it be ethical to withhold therapy?
When an intervention no longer helps to achieve the patient's goals for care or desired quality of life, it is ethically appropriate for physicians to withdraw it.
What are the patient's rights to refuse treatment?
Every competent adult has the right to refuse unwanted medical treatment. This is part of the right of every individual to choose what will be done to their own body, and it applies even when refusing treatment means that the person may die.
What happen if life-sustaining treatments are continued?
If you are near the end of your life, you may find it hard to handle the side effects and problems that can occur with these treatments. In this case, the treatments may be too much of a burden on your body. They may cause more harm than good. They may also disrupt the natural dying process and prolong suffering.
What is it called when a patient refuses treatment?
Informed refusal is where a person has refused a recommended medical treatment based upon an understanding of the facts and implications of not following the treatment. Informed refusal is linked to the informed consent process, as a patient has a right to consent, but also may choose to refuse.
What are the life sustaining measures?
Examples of life sustaining measures include artificial nutrition and hydration, cardiopulmonary resuscitation (CPR) and mechanical ventilation. Depending on the circumstances, dialysis treatments may also be considered life sustaining.
What are a few examples of when a patient can refuse treatment?
Patients may refuse treatments for many reasons, including financial concerns, fear, misinformation, and personal values and beliefs. Exploring these reasons with the patient may reveal a solution or a different approach.May 24, 2016
What is the moral right of a patient to continue life-sustaining medical treatment?
The patient's moral right to continue life-sustaining medical treatment is based on its supposed benefit to them. When that benefit fades and is lost, the moral claim to continued ventilatory support is also lost, but that is not what is proposed here.
What is the Catholic policy of unilateral withdrawal?
Another Catholic policy that justifies unilateral withdrawal states the following: "In mainstream bioethics in the United States and Catholic healthcare ethics, there is consensus that there is no moral difference between withholding and withdrawing a life-prolonging treatment.
What is the difference between baseline and triage?
In the baseline case, the intended good end and foreseen negative effect both accrue to the same person; in the triage case the negative effect is borne by one person while the good is enjoyed by another. Consider, though, Aquinas's original case, in which one may kill an unjust aggressor in self-defense; there, too, ...
What is Aquinas's original case?
Consider, though, Aquinas's original case, in which one may kill an unjust aggressor in self-defense; there, too, one person benefits at another's expense. Admittedly, Aquinas's example involves an unjust aggressor who is directly threatening one's life, which differs from the triage scenario. However, the fact that the person killed might be ...
What is the rule of double effect?
The rule of double effect is widely applied to justify various treatment interventions within Catholic health care. Paradigmatic cases include the administration of palliative medication that may hasten death or the removal of a gravid cancerous uterus resulting in fetal demise.
Is extubation a good or neutral act?
The second criterion is satisfied insofar as extubation is a good or at least morally neutral act, as it was in the non-triage case. Here, one might claim that the act in question is not merely "extubation" but the "reallocation" of the ventilator.
Does a ventilator remove a patient's potential for recovery?
Rather, it removes a ventilator from a patient whose potential for recovery is still in play in favor of another patient whose potential is presumably greater. Therefore, it is recognized that the withdrawal from the first patient must result in their death, which means we must also allow the intention of their death.
What is the dilemma of emergency medicine?
One of the greatest dilemmas for emergency physicians occurs when a patient refuses medical treatment that is necessary to sustain life and health. When patients in need explicitly refuse life-sustaining emergency treatment, the physician must choose between the undesirable options of forgoing beneficial treatment and forcing treatment on a competent but unwilling patient [1], both of which have potential ethical and legal consequences. The “emergency privilege” does not permit physicians to treat competent patients with emergency conditions who refuse treatment; but how does one assess an injured patient’s decision-making capacity?
What is the emergency exception?
The emergency exception is based on the presumption that a reasonable person would consent to treatment to preserve life and health if he or she were able. Conversely, the patient who is alert, communicative, and comprehends the situation has the ability to direct his or her health care. The grey areas lie in between.
Why is it important to assess decision making capacity?
Assessing decision-making capacity is central to providing medical care that respects patient autonomy, since patients’ consent to or refusal of medical treatment is not valid unless they are capable of making medical decisions [1].
What did the first responder tell Sachem?
The first responder’s look at Dr. Sachem told her that there was something else that couldn’t be spoken. The medics had removed much of Mr. Worther’s scorched clothing en route; when the trauma team opened the blankets, skin peeled off with the cloth and much of his body had a white sheen to it.
What are the limitations of determining DMC?
In the emergency setting, there are limitations on determining DMC. When faced with medical emergencies requiring urgent action and decision making, the emergency practitioner does not have the luxury of time to consult psychiatric professionals, an ethics committee, or hospital legal counsel.
What are the factors that affect decision making?
Decision-making capacity can be altered or obscured by pathophysiological conditions, such as acute physical or mental illness, traumatic brain injury, severe pain, pain medications, substance use (withdrawal or overdose), and emotional factors, including stress, denial, and suicidal ideation.
Who is Stephanie Cooper?
Stephanie Cooper, MD, MS is an emergency medicine physician at Harborview Medical Center in Seattle and an assistant professor at the University of Washington School of Medicine. Her academic interests are bioethics, humanities, and narrative medicine. She teaches Ethics in the ER, a course that introduces medical students to critical ethical concepts in the context of emergency medicine.