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.
Paula Tironi, JD, LLM and Monique M. Karaganis, MD
While parents often have legal authority to make decisions regarding pediatric palliative care, federal and state statutory and case laws, like CAPTA, impose significant restrictions on that authority.
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.
When serving an ethnically diverse population, it is imperative that physicians have an understanding of a patients' cultural background and attitudes towards health, nutrition and personal care.
Medical ethicists have discussed the use of race classification in determining disease prevalence and the response of specific ethnic groups to different medications.