Protecting Incapacitated Patients' Rights and Best Interests

Indian J Palliat Care. 2023 Oct-Dec;29(4):343-347. doi: 10.25259/IJPC_173_2022. Epub 2023 Nov 3.

Abstract

Contemporary medical ethics requires providing healthcare services in accordance with the patient's values, preferences and interests based on the rights to self-determination and privacy. Incapacitated patients utilise these rights through substitute decision-makers in light of the substituted judgement and best interest standards. In this context, the article aims to briefly study informed consent and focus on protecting incapacitated patients' rights and best interests. The article underscores the importance of promoting the autonomy of every patient as much as possible. However, in the case of the lack of decisional capacity and advance directives, surrogates should decide for incapacitated patients based on patients' known/documented/expressed wishes/ preferences and best interests. Nevertheless, due to the high possibility of the misinterpretation of patients' values, preferences and interests by surrogates as well as potential financial and social conflicts between patients and their surrogates, in the event of medical procedures with serious consequences, such as life-sustaining support, surrogates should be requested to provide convincing evidence proving that their decisions are in line with the patient's values, preferences and interests.

Keywords: Autonomy; Best interest; Incapacitated patients; Informed consent; Substitute decision-making.

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