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Forgoing life-sustaining treatment: limits to the consensus. Part 2.
1Kennedy Institute of Ethics, Georgetown University.
Kennedy Institute of Ethics Journal
|February 7, 1993
Summary
Discussions on forgoing life-sustaining treatment reveal gaps in consensus, particularly concerning patient refusal of treatment and care for incompetent patients. A new "reasonableness standard" is proposed to address these complex ethical dilemmas.
Area of Science:
- Bioethics
- Medical Law
- Healthcare Policy
Background:
- Substantial progress exists in moral and policy consensus regarding forgoing life-sustaining treatment.
- However, several critical gaps and controversies remain within this consensus, necessitating further public discussion and moral analysis.
- These gaps include patient refusal of treatment, damages for non-consensual treatment, third-party interests, and determining patient competence.
Purpose of the Study:
- To identify and analyze the existing gaps in the moral and policy consensus on forgoing life-sustaining treatment.
- To address controversies surrounding patient autonomy, consent, and the care of incompetent patients.
- To propose a new ethical framework, the "reasonableness standard," to navigate complex end-of-life treatment decisions.
Main Methods:
- Review of existing literature and ethical frameworks concerning life-sustaining treatment decisions.
- Analysis of legal and moral controversies related to patient competence and consent.
- Development of a proposed alternative standard for ethical decision-making in end-of-life care.
Main Results:
- Significant disputes persist regarding the refusal of certain treatments by legally competent patients.
- Greater controversy surrounds the care of incompetent patients and the application of the "best interests" standard.
- The limitations of the "best interests" standard in addressing patient-specific circumstances and conflicts of interest are highlighted.
Conclusions:
- The current consensus on forgoing life-sustaining treatment has notable deficiencies, especially concerning patient autonomy and the care of incompetent individuals.
- The proposed "reasonableness standard" offers a more nuanced approach, considering individual patient circumstances and potential conflicts of interest.
- Further ethical deliberation and public discourse are crucial to refine and implement improved standards for end-of-life decision-making.