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Patient Informed Choice for Altruism

Published online by Cambridge University Press:  17 July 2014

DAVID J. DOUKAS  and
JOHN HARDWIG
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Abstract:

Respect for persons protects patients regarding their own healthcare decisions. Patient informed choice for altruism (PICA) is a proposed means for a fully autonomous patient with decisionmaking capacity to limit his or her own treatment for altruistic reasons. An altruistic decision could bond the patient with others at the end of life. We contend that PICA can also be an advance directive option. The proxy, family, and physicians must be reminded that a patient’s altruistic treatment refusal should be respected.

Keywords

informed consentaltruismadvance directiveautonomymedical ethics
Type
Special Section: Open Forum
Information
Cambridge Quarterly of Healthcare Ethics , Volume 23 , Issue 4 , October 2014 , pp. 397 - 402
Copyright
Copyright © Cambridge University Press 2014 

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References

Notes

1. Faden RR, Beauchamp TL. A History and Theory of Informed Consent. New York: Oxford University Press; 1986.

2. Doukas, DJ, Antonucci, T, Gorenflo, D. A multi-generational assessment of values and advance directives. Ethics and Behavior 1992;2(1):51–9.CrossRefGoogle Scholar

3. Doukas, DJ, Gorenflo, D. Analyzing the values history: An evaluation of patient medical values and advance directives. Journal of Clinical Ethics 1993;4(1):41–5.CrossRefGoogle ScholarPubMed

4. Dixon, DJ, Abbey, SE. Religious altruism and organ donation. Psychosomatics 2000;41(5):407–11.CrossRefGoogle ScholarPubMed

5. Pellegrino ED, Thomasma DC. The Virtues in Medical Practice. New York: Oxford University Press; 1993.

6. See note 3, Doukas, Gorenflo 1993.

7. Matsuyama, R, Reddy, S, Smith, TJ. Why do patients choose chemotherapy near the end of life? A review of the perspective of those facing death from cancer. Journal of Clinical Oncology 2006;24(21):3490–6.CrossRefGoogle ScholarPubMed

8. Agrawal, M, Grady, C, Fairclough, DL, Meropol, NJ, Maynard, K, Emanuel, EJ. Patients’ decision-making process regarding participation in phase I oncology research. Journal of Clinical Oncology 2006;24(27):4479–84.CrossRefGoogle ScholarPubMed

9. Hampson, LA, Agrawal, M, Joffe, S, Gross, CP, Verter, J, Emanuel, EJ. Patients’ views on financial conflicts of interest in cancer research trials. New England Journal of Medicine 2006;355(22):2330–7.Google Scholar

10. Yach, D, Bettcher, D. The globalization of public health, II: The convergence of self-interest and altruism. American Journal of Public Health 1998 May;88(5):738–41CrossRefGoogle ScholarPubMed, discussion 742–4.

11. Hardwig, J. What about the family?—The role of family interests in medical decision making. Hastings Center Reports 1990;20:5–10.Google Scholar

12. Hardwig, J. The problem of proxies with interests of their own. Journal of Clinical Ethics 1993;4:20–7.Google Scholar