Author:
Dresser Rebecca S.,Robertson John A.
Abstract
Since the Quinlan decision in 1976, courts and legislatures have made substantial progress in defining rules to govern nontreatment of dying and debilitated patients. For example, the right of the competent patient to refuse necessary care is now widely established, and the legality of withdrawing respirators and even nutrition and hydration from permanently unconscious patients is increasingly recognized.More difficult questions arise, however, when the patient is neither competent nor permanently unconscious, but instead is in a conscious, severely demented and debilitated state, with experiences that appear quite limited. Thousands of patients in this condition are cared for in private homes, hospitals, and nursing homes, the victims of stroke, senility, Alzheimer's disease, and other illnesses. Even though they usually require only low-tech, minimally supportive care, such patients can impose great stress on their families and high financial costs on the health care system.
Publisher
Cambridge University Press (CUP)
Reference56 articles.
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3. 26. Competent individuals generally retain the opportunity to alter their choices to accommodate their altered interests to the extent a person's prior choices concerning career, health, residence, and promises to others permit them to do so. Incompetent persons should also be able to free themselves from prior choices when their current interests require it, and others have not changed their position in reliance on their past directives.
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