Defining the family's role in treatment decisions

Although new and complex questions concerning test-tube babies, surrogate mothers, and cross-species transplants have emerged with advancing technology, the ethical issues involved in everyday patient care have not become easier to resolve. Such questions as, What criteria should govern the withholding or withdrawal of treatment? and Who should make treatment decisions for an incompetent patient? continue to pose real dilemmas for patients, families, and care givers. As several recent court cases have shown, the issue of family autonomy in decision making is especially controversial. Whether a family's decision can be overridden if society deems it unwise and whether the interests of other individuals can be allowed to outweigh an incompetent patient's interests are questions that must be addressed in public debate. Ultimately, society must be the guardian of its most unfortunate and vulnerable when families are unprepared or ill-equipped to make critical choices.