9 ordspråk av Dr. Barry Tepperman

Dr. Barry Tepperman

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Proxies should be competent, adequately informed, emotionally stable and committed to your interests. They're expected to decide as if they were you -- that is, based on their best knowledge of your values and your beliefs and not based on their own values and beliefs or some kind of abstract best interest.

The judges had no basis for making any judgment for the medical experimentation that took place in the Nazi war camps unless they set down some rules to judge by.

He's there to offer expertise, to explain options and to keep explaining until everything is clearly understood. But the patient, sitting on the examining table in a paper gown with the wind whipping around his knees, is the only person in the room with a decision to make. As such, he makes the decision and gives consent based on the information, which includes risks and benefits weighed against his personal values.

Every treatment can potentially have an adverse effect. Everybody knows even two aspirins for a headache has a bad effect for someone somewhere. On balance, positive effects have to outweigh the negative.

I don't think there's any question in ethical thinking that if treatment is medically futile, you don't continue it. But what is 'medically futile?' Often there's no clear line.

If a person has a quality of life and an expectation for improving that are both by all evidence, by all consensus negligible, is there a general right to life?

Justice is the hardest precept for the individual physician to deal with. It asks how to best allocate resources fairly so that patients with similar situations get treated the same way.

It's the patient's expression of their values.

The family needs to know whether they want to be on a ventilator or not. Discuss those issues with your friends, your family, with anyone who is likely to have significant input when the time comes. Don't leave it to the courts to designate your proxy.

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