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As a result of the prodigious technological advances of modern medicine, physicians are increasingly confronted with the question of when, and under what circumstances, life-sustaining care should be withdrawn from terminally ill patients. In the wake of recent court decisions recognizing patients' rights to refuse medical treatment, new complexities have been introduced into the process of deciding whether so-called "extraordinary measures" should be used to prolong life.
Chief among these is the problem of determining who, in addition to the physician, should be involved in making such decisions. As the dilemma often arises in the context of treatment of patients who are incapacitated or mentally deficient and, thus, legally incompetent to render informed consent, the question of "who should decide" has emerged as the central issue facing the physician and the courts. Also of primary concern to physicians is the associated question of what legal consequences might follow from the
Suber DG, Tabor WJ. Withholding of Life-Sustaining Treatment From the Terminally III, Incompetent Patient: Who Decides?Part I. JAMA. 1982;248(18):2250–2251. doi:10.1001/jama.1982.03330180018024