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.
Asymmetry in knowledge and power between (1) physicians and patients and (2) physician educators and their students creates a climate for possible abuse in both sets of relationships.
Putting the interest of patients first means attending to what the patient thinks is most important as well as treating medically significant symptoms and conditions.
Putting the interest of patients first means attending to what the patient thinks is most important as well as treating medically significant symptoms and conditions.
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.