The change of a patient's advance directive, particularly in the context of a poor prognosis, can pose significant ethical dilemmas. On one hand, respecting patient autonomy is a fundamental ethical principle, meaning that patients have the right to make decisions about their own healthcare, including changing their advance directives. However, this conflicts with the ethical principle of beneficence, which requires healthcare providers to act in the best interest of the patient.
In the case of a poor prognosis, there may be a conflict between honoring the patient's autonomy to change their advance directive and the healthcare provider's obligation to provide care that maximizes the patient's well-being. Additionally, issues related to informed consent and decision-making capacity may arise, especially if the patient's ability to make sound decisions is compromised by their medical condition.
Healthcare providers must navigate this ethical dilemma carefully, ensuring that the patient's wishes are respected to the extent possible while also considering the potential consequences of the decision on the patient's health and well-being. Open communication with the patient and their family, as well
