Discussion: End-of-Life Decisions and Advanced Directives

Discussion: End-of-Life Decisions and Advanced Directives

Discussion: End-of-Life Decisions and Advanced Directives

What is the doctors’ role in deciding whether or not to respect Mr. Gomez’s advanced directive?
The advanced directive is rare; therefore, the doctor and the surrogates’ role is to make efforts out of good faith in respect to the patient’s goals and implement his preferences in this case where he does not have the capacity to make decisions on his own. Advance directives are a legally recognized document, and according to the law, the doctors have a responsibility to obey the patient’s wish. However, doctors can refuse to comply with the patients’ wishes if they consider the decision inappropriate if they object to conscience.

Does Mr. Gomez’s estranged wife have the authority to step in and ignore Mr. Gomez’s advanced directive? Explain your reasoning while providing evidence-based solutions in your conclusion.
A spouse does not have the automatic right to decide on behalf unless appointed as the health care proxy. Mrs. Gomez is estranged, and even though she is still the legal wife, the husband had not taken her and the agent in case of such a situation. Mr. Gomez has a health care proxy who should make decisions on his behalf; the wife can only step in to override the treatment decision if the family agrees that the decision is unappropriated. In this case, the patient is unconscious, and the doctors are not expecting him to regain consciousness.

Gomez’s estranged wife has filed temporary order to ignore the advanced directive. If you were Elena, how would you handle this dilemma? What rights does Elena have that allow her to honor her father’s wishes?
The advanced directive is a guideline that tells of how the patient wants his/her medical decisions made in case one is not in a position to do so; therefore, not even a power of attorney has the right to override this decision. Elena has the right to make decisions on behalf of the father. Consequently, I was her, I would let the mother understand the father’s condition where the doctors say that they do not expect him to regain consciousness, and on the other hand, there are the father’s wishes. The father refused to undergo dialysis even though it could help save his life, and without it, he cannot survive. Elena has the role in communicating the father’s wish at this time that he cannot do so.

What is the ethics committee’s role, and how can they best support the client and his family?
Ethics committees play an advisory role in healthcare-related dilemmas (“hospital ethics committee: Solving medical dilemmas,” 2019). They help the clinicians deal with ethical issues that arise during the clinical practice. The ethics committee carry out their role by providing families and patients with health brochures, which carry information about decision making in treatment, advanced directives, and informing them on their role. The best way that the committee can help the family is by solving the conflict between the mother and the daughter in the best way possible.


The hospital ethics committee: Solving medical dilemmas. (2019). Final Acts, 204-219. https://doi.org/10.36019/9780813549088-015


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