ETHICAL DECISION-MAKING NEAR THE END OF LIFE

The standard paradigm of decision-making asks a fully informed patient to make independent choices free of coercion. This paradigm is often insufficient for the dying patient. This article considers this standa rd, particularly in the case of attempted cardiopulmonary resuscitatio n, its alternatives, and the role of advance directives and surrogate decision-makers for patients who have lost their decision-making capac ities. The ethical concerts of therapeutic privilege, voluntary active euthanasia, as well as principle of double effect, futility, and just ice are reviewed as they apply to care of the dying patient.