Refusal of pediatric euthanasia can be considered iatrogenic insofar as it inadvertently prolongs patient suffering, but attitudes differ cross-culturally.
AMA J Ethics. 2017;19(8):802-814. doi:
10.1001/journalofethics.2017.19.8.msoc1-1708.
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.