I can’t help but think about the exceptions. A slightly ill but able patient discovering they have a terminal disease while surrounded by family seems to be the most ideal and common situation. Ask what makes their life worth living and then obey their wishes. But what do we do in situations alternative to this? What if the patient is too ill to radiate their wishes to others? What if the patient doesn’t have family? What if the patient is content with stopping the fight and a family member is not? How do consulting doctors with differing end-of-life opinions speak to and treat the same patient? What happens when the patient has dementia or a mental illness or a mental disability? What if the wrong diagnosis is made and the patient’s condition is not terminal but rather treatable? What if a patient’s desires are impractical? How does a doctor agree to a patient’s wishes without fear of lawsuits?
These are just some of the hypothetical but possible situations I could think of that I know would make the decisions very difficult. Although it might give us some relief to think that for every patient we could solve the end-of-life care problem by asking what their desires are, what’s worth living for, and what they’re willing to sacrifice for a prolonged life, it’s not that simple. I do think the method is a drastic and beneficial step forward in providing people with the best-suited care at the end-of-life, but it doesn’t give us an answer to every person’s unique situation.