Decision Making for Incompetent Patients by Designated Proxy

Abstract

Medical decisions require both technical expertise and informed consent. They should be made jointly by physicians and patients. But when the patient is incapable of participating in decision making, what should the doctor do? This question haunts contemporary discussions of medical ethics. It grabs the headlines with cases like those of Karen Ann Quinlan and the two California physicians who were accused of murdering a comatose patient by discontinuing life-sustaining treatment. It also troubles doctors who are faced with less dramatic decisions, such as whether to admit a elemented nursing-home patient to the hospital for treatment of pneumonia.¹ Joint decision . . .