Second, if the patient is not capable, who should make the decision This will depend on whether the patient has provided in advance for his or her own decision making; for example, by a lasting power of attorney (medical treatment) or by appointing an agent or a lasting guardian to make decisions when the patient is no longer able to do so. In some countries, a relative or caregiver is allowed to consent in certain circumstances (Skene, 2005).
Ethical issues begin immediately to arise at the time of diagnosis and may include whether to let the patients know the diagnosis. Giving a diagnosis can enable patients and families to plan for disability (including application for disability for those who are still employed), help ascertain patients' preferences about treatment and research participation, and facilitate support from family and community organisations (Weiner, 2004). However, this is best done in a supportive setting with adequate time to answer questions and deal with the patient's and family's emotional reaction (Post and Whitehouse, 1995). ...Show more