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Continuing problems with patient self-determination

B D White1, P A Singer, M Siegler

  • 1Saint Thomas Hospital, Nashville, TN.

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality
|January 1, 1993
PubMed
Summary
This summary is machine-generated.

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The Cruzan v. Director Supreme Court case established patient self-determination, encouraging advance directives. Physicians face practical and ethical concerns in implementing these patient rights.

Area of Science:

  • Bioethics
  • Medical Law
  • Patient Rights

Background:

  • The Supreme Court's Cruzan v. Director decision constitutionalized patient self-determination.
  • Advance directives are encouraged for competent patients facing potential incapacitation.
  • The Patient Self-Determination Act mandates hospitals inquire about advance directives.

Purpose of the Study:

  • To explore practical concerns physicians face when implementing patient self-determination principles.
  • To identify potential legal, ethical, and professional challenges for physicians.

Main Methods:

  • Legal and ethical analysis of the Cruzan decision and related legislation.
  • Identification and discussion of physician-centered practical concerns.
Keywords:
Cruzan v. Director, Missouri Department of HealthDeath and EuthanasiaLegal Approach

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Main Results:

  • Physicians grapple with potential prosecution for "assisting suicide" when withdrawing life support.
  • Concerns exist regarding medical malpractice liability for undertreatment or overtreatment.
  • Physicians may face moral dilemmas and intrusions into the physician-patient relationship.

Conclusions:

  • Successful implementation requires addressing physician concerns about legal liability, ethical conflicts, and decision-making processes.
  • Physicians need clarity on operationalizing patient self-determination within their practice.
  • Further discussion is needed to navigate the complexities of patient autonomy and physician responsibilities.