Treatment Decisions in the Mentally Impaired

In working with mentally impaired patients of any age, we frequently encounter the problem of what treatment is and is not justified. Often physicians may think that although all-out measures to preserve life — such as complicated surgery — are not justified, more simple means to treat intercurrent illness are clearly warranted. At other times, physicians feel compelled to treat even when the therapy is clearly ill advised. When patients' wishes are unknown or unknowable, physicians may treat even against their better judgment,1 not only because to do otherwise would run contrary to their innermost instincts but also because there . . .