Decision-making capacity can be preserved in patients with mental illness and should be formally assessed in the context of their values and past decisions.
AMA J Ethics. 2017;19(5):416-425. doi:
10.1001/journalofethics.2017.19.5.ecas1-1705.
When a seriously ill mature minor and his parent disagree about his receiving an experimental intervention, who should decide what treatment he will receive?
When a seriously ill mature minor and his parent disagree about his receiving an experimental intervention, who should decide what treatment he will receive?
When a seriously ill mature minor and his parent disagree about his receiving an experimental intervention, who should decide what treatment he will receive?
Even seasoned doctors can have trouble confronting the topic of death. For medical students, training and role modeling are needed to make them valuable to patients facing death.
Situations in which the patient’s family seems not to be acting in good faith or the patient's suffering is uncontrollable are relatively rare and do not warrant giving physicians unilateral power to withhold or withdraw treatment in all cases of perceived medical futility.
Forcing parents to participate in treatment is unlikely to succeed. Seeking to optimize the therapeutic alliance between family and pediatrician is more likely to achieve the desired outcome—the child’s short- and long-term well-being.