Abstract:
:Competent patients who refuse life saving medical treatment present a dilemma for healthcare professionals. On one hand, respect for autonomy and liberty demand that physicians respect a patient's decision to refuse treatment. However, it is often apparent that such patients are not fully competent. They may not adequately comprehend the benefits of medical care, be overly anxious about pain, or discount the value of their future state of health. Although most bioethicists are convinced that partial autonomy or marginal competence of this kind demands the same respect as full autonomy, Israeli legislators created a mechanism to allow ethics committees to override patients' informed refusal and treat them against their will. To do so, three conditions must be satisfied: physicians must make every effort to ensure the patient understands the risks of non-treatment, the treatment physicians propose must offer a realistic chance of significant improvement, and there are reasonable expectations that the patient will consent retroactively. Although not all of these conditions are equally cogent, they offer a way forward to assure care for certain classes of competent patients without abandoning the principle of autonomy altogether. These concerns reach past Israel and should engage healthcare professionals wary that respect for autonomy may sometimes cause avoidable harm.
journal_name
J Med Ethicsjournal_title
Journal of medical ethicsauthors
Gross MLdoi
10.1136/jme.2002.000877keywords:
subject
Has Abstractpub_date
2005-01-01 00:00:00pages
29-34issue
1eissn
0306-6800issn
1473-4257pii
31/1/29journal_volume
31pub_type
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pub_type: 杂志文章,评审
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更新日期:2017-04-01 00:00:00
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更新日期:2020-10-26 00:00:00
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pub_type: 杂志文章
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journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2009.034967
更新日期:2010-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:1998-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:1982-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1136/medethics-2012-100715
更新日期:2014-05-01 00:00:00
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更新日期:2018-08-01 00:00:00
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journal_title:Journal of medical ethics
pub_type: 杂志文章,多中心研究
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更新日期:2014-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:1980-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-01-01 00:00:00
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pub_type: 评论,杂志文章
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更新日期:1999-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-08-01 00:00:00
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更新日期:2015-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-01-01 00:00:00