The Patient Said He Would Rather Die: Should You Let Him?

Abstract

It is a well-established canon of law in the United States that every person has the right to determine what happens to his own body, including refusal of life-sustaining treatment. Surgeons often find it difficult to accept prima facie a patient’s refusal of a life-saving operation that the surgeon knows can be done with a reasonable degree of success. Fortunately, we do not face that problem very often, but when we do, we frequently struggle with how to handle the situation, because usually no simple answers are evident. Just such a fictional case — a rupturing aortic aneurysm — was presented for debate at the 98th Annual Meeting of the American Association for Thoracic Surgery, pitting a professor of law with expertise in bioethics against a highly experienced cardiothoracic surgeon with a distinctly contrary view.

Keywords: Ethics, Health policy, Professionalism, Informed consent

JEL Classification: K10, K32