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).
AMA J Ethics. 2017;19(4):374-380. doi:
10.1001/journalofethics.2017.19.4.stas1-1704.
The WHO Clinical Staging System for HIV/AIDS allows physicians in resource-limited settings to make clinical decisions based on patient clinical features instead of laboratory tests.
Asymmetry in knowledge and power between (1) physicians and patients and (2) physician educators and their students creates a climate for possible abuse in both sets of relationships.