Question

A patient has an advanced directive stating a desire to forego medical technology, including nutrition and hydration, in order to prolong life. The patient is now in an irreversible vegetative state. In deciding whether to continue nutrition and hydration by medical means, the patient's surrogate decision-maker must:

1: consult with a lawyer.
2: have a psychiatric evaluation to be declared competent to make any decisions in the patient's care.
3: honor the patient's expressed wish to withdraw nutrition and hydration by medical means.
4: decide, based upon own values, to make a decision to withdraw the patient's nutrition and hydration by medical means.

Answer 1

The surrogate decision-maker must honor the patient's expressed wish to withdraw nutrition and hydration by medical means, as outlined in the patient's advance directive. Legal consultation or a psychiatric evaluation is not required for the surrogate, and the surrogate should not base the decision on personal values.

Step-by-step explanation:

When considering the case of a patient in an irreversible vegetative state with an advance directive, the patient's surrogate decision-maker must honor the patient's expressed wish to withdraw nutrition and hydration by medical means. The surrogate is expected to respect the patient's autonomy and previously stated decisions regarding end-of-life care, which may include do not resuscitate (DNR) orders or preferences concerning life-sustaining treatments. It's important to note that the surrogate does not need to consult with a lawyer, have a psychiatric evaluation, or impose their personal values in the decision-making process, as long as the patient's wishes are clear and documented.

The case of Terri Schiavo provides a significant example where the patient's expressed wishes can guide the surrogate's decisions despite external pressures or personal beliefs. Understanding and upholding a patient's advanced directive falls within the legal and ethical frameworks of patient rights and medical ethics, which underscore the importance of respecting a person's autonomy in healthcare decisions.