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.
Despite drawbacks of immunosuppression and surgery, vascularized composite allotransplants can enhance lives of patients who meet candidacy criteria and are well supported.
AMA J Ethics. 2019;21(11):E968-973. doi:
10.1001/amajethics.2019.968.