MCQ Pediatrics Answer 38

The Correct Answer is A


Competent adult patients have the right to refuse any medical intervention, even if forgoing this treatment may result in their death.

Legally and ethically it does not matter whether the patient requests that care be withheld before it is started, or that it be withdrawn once it is begun.

All states currently allow competent patients to legally designate a health-care proxy to make these decisions for them if they become unable to communicate or incompetent to decide for themselves. The patient in this example has instituted such a legal advance directive and his proxy's desires should be respected as his own and the care withdrawn.

If there were no advance directive the decision in this case would become more difficult, and might require a family conference or the involvement of an ethics committee. A patient's condition does not need to be terminal or irreversible in order to allow the removal of life-sustaining therapy.

Legal involvement is rarely required in situations where advance directives are already available and valid.


Ref:

• Emanuel EJ: A review of the ethical and legal aspects of terminating medical care. Am J Med 1988; 84(2):291-301. 2)
• Doukas DJ, Reichel W: Planning For Uncertainty: A Guide to Living Wills and Other Advance Directives for Health Care. The Johns Hopkins University Press, 1993, pp 7-9, 26-27. 3)
  
• Rake! RE: Textbook of Family Practice, ed 6. WB Saunders Co, 2002, pp 144-146.

Category: Pediatrics MCQs