Quiz: Advance Directives (Id:767950)
Question 2 of 2
A 65-year-old woman with a history of chronic obstructive pulmonary disease and kidney failure decides that she does not want mechanical
ventilation or dialysis. Which of the four pillars of medical ethics is the most prominent in her decision?
Well done! You answered successfully
A. Positive autonomy
B. Substituted judgment
C. Negative autonomy
D. Beneficence
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Teaching Points
The four pillars of medical ethics are autonomy, beneficence, non-maleficence, and justice. Advance directives allow
patients to exercise their autonomy even when they can no longer speak for themselves. Autonomy is primarily negative
autonomy, i.e., a patient has the right to refuse any treatment, even if that treatment could prolong their life.
Positive autonomy plays a lesser role in choosing therapies she wants; however, those desires are limited by whether or not
they are medically appropriate, e.g., she could not request chemotherapy if she does not have cancer or some other
indication.
Exercising autonomy requires a patient to understand the medical condition, available treatments, associated risks, and the
potential health consequences of declining treatment.
Beneficence is to do good for the patient. If an intervention is not likely to be beneficial, in general, it should not be offered.
Non-maleficence is the traditional "Do no harm," i.e., interventions wherein the risks outweigh the benefits should not be
offered. Justice is distributive justice or the appropriate distribution of finite resources. For example, mechanical ventilation
is best used for patients with a reasonable chance of recovery rather than for those who are expected to die despite the
intervention. This is not a determination of whose life is more important; instead, it is a decision regarding which patient is
expected to benefit the most from an intervention.
How Other Users Answered
StatPearls Topic: Advance Directives
PubMed References: Advance Directives
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Question Details
Last Updated:
4/29/2022 9:43:51 PM
Quiz Type:
Study Mode
Question Author:
Steven A. House
Caroline Schoo
Article/Question Editor:
Wes A. Ogilvie
Anatomical Science:
Pulmonary, Renal
Difficulty Level :
Level 2 - Moderate
Clinical Science:
Legal, Healthcare Ethics
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