PHL281H1 Lecture Notes - Lecture 11: Advance Healthcare Directive, Nasogastric Intubation, Urinary Catheterization
14 Dec 2016
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Court: she has a right to be treated the way her family thought she would have wanted. Off life support- could breathe on her own. Elderly woman in nursing home w/ dementia. Confined to bed, heart disease & diabetes, gangrene to the knee, bed sores, eye problems, no bowel control, urinary catheter, can"t speak. Not unconscious- could move her body, followed people w/ eyes. Smiled when hair combed & given a comforting rub. Nephew appointed her guardian- petitions for tube removal. Different from quinlan: she"s conscious, but incompetent. Goal to find decision that patient would have made if competent. Order of decision-making standards: the: advance directive, substituted judgement- what would patient have wanted if suddenly competent, best intrest standard. Incompetent persons must be treated as autonomous choice-makers: patient autonomy is still treated as important, even though patient is no longer competent. Expressed or inferred prior choices are not accurate indicators of incompetent persons" current interests.
