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.
“Difficult” patient encounters can be exacerbated by procedural and technological infrastructure that increases access to electronic health records (EHRs).
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.
A physician who is undergoing a setback in his or her private life can reassure patients and avoid losing their respect by maintaining a professional demeanor in the office.