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Asking Too Much: Autonomy and Responsibility at the End of Life

Journal of Contemporary Health Law and Policy, Vol. 26, p. 72, 2009

11 Pages Posted: 19 Feb 2010  

Lois L. Shepherd

University of Virginia Center for Biomedical Ethics and Humanities; University of Virginia School of Law

Date Written: 2009

Abstract

This essay identifies four situations in which limits to patient choices about life-sustaining treatment should be recognized, even when those choices are clearly expressed and carefully documented. The four situations are (1) the refusal of medical treatment in a suicide attempt, (2) the request for futile treatment, narrowly defined, (3) the refusal of hand feeding by surrogate or advance directive, and (4) the refusal of non-burdensome treatment for people who become profoundly disabled but are neither permanently unconscious nor terminally ill or injured. In each of these situations, patient demands (by proxy or otherwise) are unreasonable because they ask people to deny their basic impulses to treat others humanely. The author argues that not only do individuals have no right to make such demands, they have a responsibility not to make them.

Keywords: autonomy, patient, end-of-life, life-sustaining treatment, hand feeding, futile treatment, suicide, minimally conscious, michael martin, advance directive, living will, health care proxy, patient responsibility, patient rights, Wooltorton, Motl Brody, surrogate decision-making, substituted judgment

Suggested Citation

Shepherd, Lois L., Asking Too Much: Autonomy and Responsibility at the End of Life (2009). Journal of Contemporary Health Law and Policy, Vol. 26, p. 72, 2009. Available at SSRN: https://ssrn.com/abstract=1553228

Lois L. Shepherd (Contact Author)

University of Virginia Center for Biomedical Ethics and Humanities ( email )

Box 800758
Charlottesville, VA 22901
United States
434-982-3970 (Phone)

University of Virginia School of Law

580 Massie Road
Charlottesville, VA 22903
United States

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