Can Caregivers Ever Say No?

In "Models of Relational Medical Decision-Making: Caregivers and Advanced Life-Sustaining Treatment," Aaron Wightman and Georgina Campelia describe a set of increasingly nuanced models for decision-making about advanced life-sustaining technologies when unpaid familial or other relational medical caregivers are required for patient welfare. Decision-making poses many challenges for caregivers, care recipients, and clinicians. Here, I discuss three related to the possibility that a presumed caregiver might say no: coercive circumstances that make "refusal" challenging as a live possibility, difficulties with the "informed" part of a caregiver's informed consent and refusal, and the possibility that caregiving of this sort is ultimately shot through with inevitable moral failures not because the caregiver is a bad person or making bad choices but rather because such caregiving is all too often a case of when doing the right thing is impossible.