Family Health Care Decisions

Theological/Ethical Reflection

·       Hope and meaning in life are possible even in times of suffering and adversity

·       respecting the integrity of an individual includes respecting their preferences about treatment decisions

·       decisions of incompetent  patients who have identified their wishes through advance directives, living wills, and/or conversation with family
        or designated surrogates should also be respected

Background

In 1993 the New York State Task Force on Life and the Law issued recommendations that would

·       establish protocol for who makes decisions about treatment for patients without capacity

·       contains safeguards to promote decisions based on patient’s wishes or if unknown, the patient’s best interests.

Currently in New York State

·       only a court-appointed guardian or a judge is permitted to consent to treatment for patients who lack capacity to decide for themselves
        even when a family  member is willing and able to act on their behalf.

·       No one, not even a judge, can decide to forego life-sustaining measures for patients without capacity, unless the patient has signed a
        health care proxy or left   “clear and convincing evidence” of treatment wishes.

·       Most people never leave this kind of evidence, so incapacitated patients are routinely at risk of receiving treatments that violate their
        wishes, values, or religious beliefs.

What would help

New York needs a law that

·       enables surrogate decision makers  to make decisions consistent with an incapacitated patients’ wishes, or if not known, in the best
        interest of the patient.  

·       establishes a protocol to determine who shall consult with physicians and other professionals responsible for the care of the patient and
        make surrogate decisions

·       defines medical criteria that must be satisfied to withhold or withdraw life-sustaining treatment

·       gives family members and other surrogate decision-makers access to incapacitated patients’ medical records.

·       provides mechanisms for facilitating access to treatment for incapacitated patients who have no family or friends available to make
        decisions.

·       clarifies procedures to follow when there is objection or disagreement about life-sustaining treatment

·       triggers review by an interdisciplinary ethics committee if disputes arise regarding decisions.

                                                        5/2005