Case and Commentary

Jan 2005

Respecting Patients' End-of-Life Decisions, Option Assessment

Karine Morin, LLM
Virtual Mentor. 2005;7(1):87-95. doi: 10.1001/virtualmentor.2005.7.1.ccas15a-0501.

 

A. Because Mrs. Scott apparently has decision-making capacity, ordering the removal of the PEG tube is preferable and supported by the Codein Opinion 2.20, "Withholding or Withdrawing Life-Sustaining Medical Treatment": "The principle of patient autonomy requires that physicians respect the decisions to forego life-sustaining treatment of a patient who possesses decision-making capacity."

B. Asking Mr. Scott to persuade Mrs. Scott to keep the PEG tube should be avoided. It is not supported by, and may violate the Code in Opinion 2.20, "Withholding or Withdrawing Life-Sustaining Medical Treatment": "The principle of patient autonomy requires that physicians respect the decisions to forego life-sustaining treatment of a patient who possesses decision-making capacity."

C. Calling for a psychological evaluation of Mrs. Scott should be avoided because it is not a sensible alternative unless Mrs. Scott has given some indication that she may lack decision-making capacity. If she has not, then this is merely an attempt to circumvent her autonomy which violates the Code in Opinion 2.20, "Withholding or Withdrawing Life-Sustaining Medical Treatment": "The principle of patient autonomy requires that physicians respect the decisions to forego life-sustaining treatment of a patient who possesses decision-making capacity."

D. Informing Mrs. Scott that he will not remove the PEG tube should be avoided because it violates the Code in Opinion 2.20, "Withholding or Withdrawing Life-Sustaining Medical Treatment": "The principle of patient autonomy requires that physicians respect the decisions to forego life-sustaining treatment of a patient who possesses decision-making capacity."

Compare these options

Citation

Virtual Mentor. 2005;7(1):87-95.

DOI

10.1001/virtualmentor.2005.7.1.ccas15a-0501.

The people and events in this case are fictional. Resemblance to real events or to names of people, living or dead, is entirely coincidental. The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.