Navigating ethical conflicts between advance directives and surrogate decision-makers' interpretations of patient wishes

Courtenay R. Bruce; Trevor Bibler; Andrew M. Childress; Ashley L. Stephens; Adam M. Pena; Nathan G. Allen

doi:10.1378/chest.15-2209

Navigating ethical conflicts between advance directives and surrogate decision-makers' interpretations of patient wishes

Courtenay R. Bruce, Trevor Bibler, Andrew M. Childress, Ashley L. Stephens, Adam M. Pena, Nathan G. Allen

Research output: Contribution to journal › Review article › peer-review

13 Scopus citations

Abstract

There is little guidance on what clinicians should do when advance directives (or living wills, specifically) are challenged, particularly when surrogate decision-makers' interpretations of patients' wishes conflict with the living will. In our commentary, we make a controversial argument suggesting that overriding living wills can be ethically preferable to the alternative of strictly adhering to them. We propose four ethical considerations for determining whether it is ethically supportable to override living wills.

Original language	English (US)
Pages (from-to)	562-567
Number of pages	6
Journal	CHEST
Volume	149
Issue number	2
DOIs	https://doi.org/10.1378/chest.15-2209
State	Published - Feb 2016

Keywords

Commentary
Critical care
End of life
Medical ethics
Quality of life

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

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10.1378/chest.15-2209

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title = "Navigating ethical conflicts between advance directives and surrogate decision-makers' interpretations of patient wishes",

abstract = "There is little guidance on what clinicians should do when advance directives (or living wills, specifically) are challenged, particularly when surrogate decision-makers' interpretations of patients' wishes conflict with the living will. In our commentary, we make a controversial argument suggesting that overriding living wills can be ethically preferable to the alternative of strictly adhering to them. We propose four ethical considerations for determining whether it is ethically supportable to override living wills.",

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AU - Stephens, Ashley L.

AU - Pena, Adam M.

AU - Allen, Nathan G.

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AB - There is little guidance on what clinicians should do when advance directives (or living wills, specifically) are challenged, particularly when surrogate decision-makers' interpretations of patients' wishes conflict with the living will. In our commentary, we make a controversial argument suggesting that overriding living wills can be ethically preferable to the alternative of strictly adhering to them. We propose four ethical considerations for determining whether it is ethically supportable to override living wills.

KW - Commentary

KW - Critical care

KW - End of life

KW - Medical ethics

KW - Quality of life

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Navigating ethical conflicts between advance directives and surrogate decision-makers' interpretations of patient wishes

Abstract

Keywords

ASJC Scopus subject areas

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