For each of the following scenarios involving end-of-life care or surrogate decision-making, identify the corresponding ethical principle, legal standard, or directive that dictates or justifies the medical approach.
- Administering high-dose analgesics to a patient with a terminal illness to relieve severe pain, with the foreseeable but unintended consequence of respiratory depression.Principle of double effect
- A designated surrogate refusing a feeding tube for a patient with advanced dementia by relying on the patient's prior verbal statements and known values.Substituted judgment standard
- Parents deciding to transition to comfort measures for an adult child who has had profound cognitive impairment since birth, basing the choice on maximizing relief from suffering.Best interest standard
- A medical team withholding endotracheal intubation based on a patient's previously executed, formal written document specifying treatments she wishes to avoid in an irreversible coma.Living will
Cevap
The correct matches are: 1 matches Principle of double effect, 2 matches Substituted judgment standard, 3 matches Best interest standard, 4 matches Living will.
Each scenario aligns with a core ethical or legal standard in end-of-life care. Giving opioids for pain that may hasten death relies on the principle of double effect. Using a patient's prior statements to guide surrogate decisions represents substituted judgment. Deciding for a patient who never had capacity requires the best interest standard. A written instructional directive is a living will.
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Anahtar Kavram
Ethical principles and legal frameworks in end-of-life care require distinguishing between surrogate standards (substituted judgment vs. best interest), instructional directives (living wills), and justifications for interventions with dual outcomes (double effect).