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The Role of the Patient’s Family, Surrogate and Guardian at the End of Life

Raphael Cohen-Almagor


The aim of this paper is to explore the intricate issue of the right to die in dignity by focusing on the role of the patient’s family. The paper considers a number of real-life cases. The cases demonstrate the importance of caution in incidents when the best interests of the patient’s family members contradict the best interests of the patient. There is some resemblance between two American cases: Spring and Wendland. But while in Spring the family was unified in its opinion to stop the patient’s treatment, in Wendland family members expressed contrasting opinions. Two English cases - In Re N and In Re 62-year-old Woman and a Dutch case concerning Mrs A, highlight the important role of the incompetent patient’s family when members of family are unified in their opinions. These cases lead to conclude, contra Dworkin, that advance directives should be treated with great caution.


Advance directive, autonomy, care, clinical judgement, compassion, dignity, end-of-life, euthanasia, guardian, intellectual competence, patient’s best interests, patient’s family, person-centered healthcare, shared decision-making

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