"Please Keep Mom Alive One More Day"-Clashing Directives of a Dying Patient and Her Surrogate

Abstract

All medical care providers are legally and ethically bound to respect their patients' wishes. However, as patients lose decision-making capacity and approach end of life, their families or surrogates, who are confronted with grief, fear, self-doubt, and/or uncertainty, may ask physicians to provide treatment that contradicts the patients' previously stated wishes. Our work discusses the legal and ethical issues surrounding such requests and provides guidance for clinicians to ethically and compassionately respond-without compromising their professional and moral obligations to their patients.

Keywords: Multiple myeloma; end-stage renal disease; ethics; hemodialysis; moral distress; surrogate decision maker.