THE LIMITS OF PROXY DECISION-MAKING - UNDERTREATMENT

With the passage by virtually every state legislature of healthcare proxy laws, the medical profession increasingly can expect to rely on the participation of surrogates in making decisions on behalf of incompetent patients. Several concerns about the legitimacy of proxy decision making have been discussed in the ethical and general medical literature: the lack of concordance between the views of patients and their surrogates have been documented on multiple occasions,1,2 and cases of abuse by proxies3 or potential conflict of interest4 have been reported. Another dilemma that deserves discussion arises when proxies demand withdrawal of treatment that physicians and nurses regard as essential to the well-being of the patient. The following case highlights this dilemma. © 1995, Cambridge University Press. All rights reserved.