Protective Durable Power Of Attorney For Health Care (Page 3 of 8) in pdf

Principles for Making Moral Medical Decisions

By Julie Grimstad

1. No matter what life-sustaining procedure/medical treatment is in question, when in doubt,

err on the side of life. You can always try an intervention with the option of stopping it if it

proves ineffective or excessively burdensome for the patient.

2. It is the physician’s obligation to truthfully and fully, in layperson’s terms, discuss with the

patient/agent/family/guardian the benefits, risks, cost, etc. of all available medical means that

may improve the patient’s condition or prolong life. The focus should be on what the person

making medical decisions needs to know in order to give truly informed consent.

3. The patient/agent makes the decision whether or not a particular treatment is too

burdensome. If the patient wishes to fight for every last moment of life, it is his/her right to

receive/continue treatment and care that might extend life.

4. It is impossible to make morally sound, sensible, informed health care decisions based on

guesswork about some future illness or injury/treatment options. Health care decisions must be

based on current information.

5. Two extremes are to be avoided:

 Insistence on useless or excessively burdensome treatment even when a patient may

legitimately wish to forgo it.

 Withdrawal or withholding of treatment with the intention to cause death.

6. The object and motive for administering pain medication must be to relieve pain; death

must not be sought or intended.

7. Nutrition and hydration, whether a person is fed with a spoon or through a tube, is basic care,

not medical treatment. Insertion or surgical implantation of a feeding tube takes medical

expertise, but it is an ordinary life-preserving procedure for a person who has a working

digestive system but is unable to eat by mouth. Circumstances and intent determine the

morality of withholding food and fluids.

 Acceptable - During the natural dying process, when a person’s organs are shutting

down so that the body is no longer able to assimilate food and water or when their

administration causes serious complications, stopping tube-feeding or spoon-feeding is

both medically and morally appropriate. In these circumstances, the cause of death is

the person’s disease or injury, not deliberate dehydration.

 Unacceptable - When a person is not dying—or not dying quickly enough to suit

someone—food and fluids are often withheld with the intent to cause death because the

person is viewed as having an unacceptably low quality of life and/or as imposing

burdens on others.

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