Är du död än? - En analys av anhörigas inflytande över vården i olika skeden
Sammanfattning: The Swedish constitution provides a general protection against enforced interventions. This includes practically all interventions in healthcare. The result is that all medical interventions must be supported by the patient's consent or by law. Swedish law provides no solution if a patient lacks the mental capacity to give consent for an intervention and the laws regarding involuntary treatment are not applicable. A governmental commission has put forth a proposal for a new law about surrogate decision-making. The proposal enables those close to the patient to act as surrogate decision makers. If no such person is available, the caregiver itself may carry out the decision on its own. The surrogate is however not allowed to refrain from live support. Another area where persons close to the patient plays a role is organ donation. If the deceased has not made its will known the law still allows organ transplant, as long as the deceased has not opposed it in any way. Those close to the patient may however in these cases use a veto to stop a transplantation. This essay uses a legal dogmatic method to investigate the motives for close ones’ influence in the healthcare, and what these decisions should be based on. There is a slight difference between the protected interests regarding healthcare given to patients without mental capacity and donation of organs. In relation to healthcare the interest at hand is the one of the patient only. However, when discussing organ donation, the interest of the psychological integrity of the people close to the deceased person is considered as well. This difference of considered interests is most of the time logical, though there are a few situations in healthcare which resembles the organ donation situation a lot more than the rest of the healthcare situations. Instead of letting the considered interests approach when the situations become more alike, the proposal for surrogates leads to a huge difference in very similar situations. As an alternative, the patient could be enabled to decide for its own how the surrogate should make its decisions, a solution which is discussed. This could also mean that the patient could allow the surrogate to refrain from life support.
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