Case Studies

An elderly patient with chronic lung disease is reluctant to undergo hip surgery because she fears possible ventilator dependency and coma. She will consent to the operation if her surgeon will agree to be legally obligated to remove the ventilator after a specified time. Lederer, a physician, objects to this application of patient autonomy because it might place the surgeon in legal jeopardy of collusion in suicide and would undermine the principles of nonmaleficence and mutual trust. Brock, a philosophy professor, supports the patient's desire for giving advance instructions about her care; allays the surgeon's legal concerns; and rejects any moral distinction between initiating and withdrawing treatment. He suggests modifications in the advance directive agreement that would be acceptable to the patient yet preserve the physician's responsibility to exercise his professional judgment without violating his moral or professional integrity

Autonomy · Business · Collusion · Directive · Medical emergency · Political science · Professional responsibility · Ethics in medical practice · Law · Medicine · Palliative Care and End-of-Life Issues · Patient Dignity and Privacy · Psychology

• Debating a Duty to Treat

  Paul Wallis•Bulletin of the history of medicine•2011

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