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Whose death is it, anyway?

T Gilligan¹, T A Raffin

¹Stanford University Center for Biomedical Ethics, California, USA.

Annals of Internal Medicine

|July 15, 1996

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Advance directives aim to ensure patient autonomy in end-of-life care. However, even valid directives may be overridden, highlighting challenges in physician-patient relationships and end-of-life decision-making.

Area of Science:

Medical Ethics
Patient Autonomy
End-of-Life Care

Background:

Critically ill patients often lose the capacity for decision-making.
Advance directives were created to uphold patient wishes when incapacitated.
Legal rights to refuse treatment exist for competent patients.

Discussion:

A case illustrates that valid advance directives may not prevent unwanted medical interventions.
Physicians may disregard patient directives due to issues of power and control.
This reflects an ongoing tension in the physician-patient relationship.

Key Insights:

Physician adherence to advance directives is inconsistent.
Defining medical success solely by life-prolongation can conflict with patient values.

Keywords:

Death and Euthanasia Professional Patient Relationship

Related Experiment Videos

Patient-centered care requires understanding meaningful existence beyond mere survival.

Outlook:

There is a need for improved communication and respect for patient autonomy in end-of-life care.
Re-evaluating physician training to prioritize patient-defined quality of life is crucial.
Strengthening the enforceability of advance directives is necessary.