This case study examines the circumstance of a patient who has clearly articulated non-treatment preferences and who then later becomes incapacitated. The patient's wife as well as a consulting physician both expressed a preference for full treatment at the time of this incapacity. The analysis of this circumstance is pertinent given misinformed beliefs by health care providers that once a patient is incapacitated, the family is free to override prior values and preferences. The analysis discusses the autonomy, beneficence, and virtue-based considerations as to why a formerly capacitated patient who has not recanted his non-treatment preferences should be obeyed.
BeauchampTLChildressJF. Principles of Biomedical Ethics. 8th Ed. New York: Oxford University Press, 2019.
2.
PhillipsJWendlerD. Clarifying substituted judgment: the endorsed life approach. J Med Ethics2015; 41: 723–730.
3.
Department of Veterans Affairs, Veterans Health Administration, VHA Handbook 1004.03(2) Life-Sustaining Treatment Decisions: Eliciting, Documenting and Honoring Patients’ Values, Goals And Preferences, Washington, DC, January 11, 2017, Amended May 10, 2021.
4.
FadenRRBeauchampTLKingNMP. A History and Theory of Informed Consent. 1st ed. New York: Oxford University Press, 1986.
