Match each ethical principle or legal framework regarding end-of-life decision-making with its corresponding clinical scenario or characteristic description.
- Principle of double effectAdministering escalating doses of morphine to treat refractory dyspnea in a terminally ill patient, knowing it may depress respiratory drive.
- Substituted judgment standardA surrogate decision-maker refusing intubation for an incapacitated patient by stating, "He told me last year he never wanted to be on a breathing machine."
- Best interest standardWithdrawing life-sustaining therapies from a pediatric patient or an adult without prior known wishes based on consensus that continued treatment provides no benefit.
- Physician Orders for Life-Sustaining Treatment (POLST)A portable medical document that translates a patient's preferences into actionable, out-of-hospital orders for emergency medical personnel.
Cevap
Principle of double effect matches the administration of morphine for dyspnea; Substituted judgment standard matches the surrogate deciding based on past statements; Best interest standard matches decisions for patients with unknown wishes; POLST matches the portable out-of-hospital medical orders.
Each ethical framework and legal document has a specific scope of application in end-of-life care. The principle of double effect addresses intent in symptom management. Surrogate decisions follow a hierarchy: express directives, substituted judgment (based on known values), and finally the best interest standard (when values are unknown). POLST forms differ from living wills by providing immediately actionable medical orders.
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Anahtar Kavram
End-of-Life Ethical Principles and Surrogate Decision-Making Standards