Treatment decision making: who should decide?

Why is someone other than a competent adult patient considered to be the person to make important treatment decisions? Since one's values influence decision making, who other than the patient should make these significant decisions? The author argues that competent adult patients should make treatment decisions because of the moral nature of these decisions. Recommendations for facilitating the patient's active involvement include increasing one's understanding of values, autonomy, and decision making; identifying personal values; creating a supportive environment; educating patients about their role in decision making; and advocating for patient involvement in treatment decisions.