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.
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.
Paula Tironi, JD, LLM and Monique M. Karaganis, MD
While parents often have legal authority to make decisions regarding pediatric palliative care, federal and state statutory and case laws, like CAPTA, impose significant restrictions on that authority.
People with mental illness or a degenerative mental disease have special protections under the law when entering into contracts or other binding documents.