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.
Patricia M. Davidson, PhD, RN, Cynda Hylton Rushton, PhD, RN, Jennifer Dotzenrod, MPP, Christina A. Godack, MA, Deborah Baker, DNP, CRNP, and Marie N. Nolan, PhD, RN
The nursing profession can become more inclusive by fostering a supportive culture, resilience, and realistic expectations for people with disabilities.
AMA J Ethics. 2016;18(10):1034-1040. doi:
10.1001/journalofethics.2016.18.10.msoc1-1610.
Because regulatory approval of cognitive enhancement drugs is likely, physicians may want to consider whether they would condone the practice for restoration of function only or for enhancement purposes as well.
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.