Testing the Medical Covenant: Caring for Patients with Advanced Dementia
Version of Record online: 27 MAR 2012
© 2012 American Society of Law, Medicine & Ethics, Inc.
The Journal of Law, Medicine & Ethics
Volume 40, Issue 1, pages 45–50, Spring 2012
How to Cite
May, W. F. (2012), Testing the Medical Covenant: Caring for Patients with Advanced Dementia. The Journal of Law, Medicine & Ethics, 40: 45–50. doi: 10.1111/j.1748-720X.2012.00644.x
- Issue online: 27 MAR 2012
- Version of Record online: 27 MAR 2012
End-of-life care, particularly for patients with advanced dementia, tests the medical covenant, both the integrity and aptness of what physicians have to offer and the fidelity with which they offer it. This article considers five ways of justifying the unilateral withholding of future treatment: (1) an affirmation of professional autonomy; (2) a defense of professional integrity; (3) a parentalist exercise of power on behalf of the patient and/or family; (4) a protection of the interests of third parties (footing the bill); or (5) a protection of the interests of second parties (the physician or other providers). The article concludes with a sixth response to care for the stricken patient and family that seeks to attend more fully to the clinical reality of bonded humans in the throes of disease and death.