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Practical Question Answer

Is there a legal right to refuse medical interventions? Yes. The U.S. Supreme Court declared that competent people have a constitutionally protected right to refuse unwanted medical treatments based on the 14th Amendment.

Despite extensive public support for use of advance care directives and the passage of the Patient Self-Determination Act mandating that health care institutions inform patients of their right to complete such documents, only about 20% of Americans have completed one. Data suggest that attention generated by the Schiavo case appears to have increased completion of advanced directives by Americans to more than 30%. Efforts to improve completion of advance care directives have generated mixed results; even successful pilot efforts have not been adopted or reproduced widely. A persistent problem has been that even when patients complete advance care directives, the documents frequently are not available, physicians do not know they exist, or they tend to be too general or vague to guide decisions.

Who decides about terminating life-sustaining interventions if the patient is incompetent? If the patient appointed a ***** or surrogate decision maker when competent, that person is legally empowered to make decisions about terminating care. If no ***** was appointed, there is a legally designated hierarchy, usually (1) spouse, (2) adult children, (3) parents, (4) siblings, and (5) available relatives.

TERMINATION OF MEDICAL INTERVENTIONS

Whose view about terminating life-sustaining interventions prevails if there is a conflict between the patient and family? The views of a competent adult patient prevail. It is the patient's body and life.

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