Advance directives, substituted judgment, and the best-interest standard all have limitations that constrain their usefulness in making medical decisions for patients who cannot choose for themselves.
The practice of banking sperm from adolescents about to undergo chemotherapy is not universal, which lends support to the argument that parental consent be required for the intervention.
Good ethics and good business don’t have to be in conflict. Ophthalmologists shouldn’t resort to requiring their patients to buy contact lenses in-house; instead, they should focus on expanding their skill set and providing personalized service.
Advance directives do not always resolve questions about the best care for patients who no longer have decision-making capacity; physicians and patient surrogates can take alternative approaches to arrive at the best care decision.
Clinical and psychosocial considerations influence how oncologists approach discussing sperm banking with adolescent patients who are about to undergo chemotherapy and with the parents of those patients.