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.
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.
Much premed education encourages acquiring competence in basic science and demonstrating (rather than developing) the characteristics of a good physician.
PRIME-LC is a 5-year, dual-degree program at the University of California, Irvine Medical School that educates physician activists to serve in poor Latino communities.