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.
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.
The profession of medicine is duty-bound to further the best interests of the public. If evidence suggests that discrimination based on sexual orientation or denial of civil marriage to GLBT couples has adverse effects on their health, physicians must oppose such practices, regardless of their personal biases.
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.
Unclear regulations and informal data gathering on immigrants who receive or donate organs can cause mistrust and suspicion of the organ allocation system and affect donation rates.
An argument that the concept of judicious dissent can resolve the debate over a physician’s conscience-based right to refuse to provide lawful services.
An argument that an individual physician’s conscience-based decision not to offer specific, lawful medical services should not restrict patients’ access to those services.