The prisoner dilemma: Inconsistent decisions for continuing life-sustaining treatment between a patient with very limited communication and their surrogate

Abstract

This case raises the difficult question of how to respond to patients who appear to lack decision-making capacity, yet retain limited communication that allows them to state a preference for life-sustaining treatment that conflicts with the choice of their surrogate. I argue that the patient’s preference should be honored, even though the patient lacks decision-making capacity, and the preference contradicts the wishes of the surrogate.