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.
Nancy Berlinger, PhD and Annalise Berlinger, BSN, RN
Physicians’ reliance on “culture” to explain patients’ noncompliance may serve as code for their discomfort with difference, uncertainty, and distress.
AMA J Ethics. 2017;19(6):608-616. doi:
10.1001/journalofethics.2017.19.6.msoc1-1706.
Amanda Fakih, MHSA and Kayte Spector-Bagdady, JD, MBE
Testing everyone for everything identifies more fetal conditions, but confusion persists about whether clinicians should leave screening decisions to patients.
AMA J Ethics. 2019;21(10):E858-864. doi:
10.1001/amajethics.2019.858.
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.