What do you do if a patient's best interests conflict with their family's wishes?

In many instances it could be that the family and patient have received different information about treatment options or prognosis and are therefore making their decisions based on different facts. It could also be that each party doesn't want to 'burden' the other, so are making altruistic decisions. Open communication is important, but think about what type of setting will allow the patient and their family to speak freely - often it won't be as a big open family meeting with all multidisciplinary team members present. Team members that have good rapport with the patient/family could have separate one-on-one chats initially, so that differences of opinion can be shared sensitively in any follow-up group meetings.

Navigating conflicts between a patient's best interests and their family's wishes is a complex and challenging task wherein it's crucial to maintain communication for better understanding of each party's perspectives and concerns. During the process ethical considerations should be adhere to by upholding ethical principles such as beneficence, autonomy, and justice. It is also important to see if the patient has previously expressed their wishes through advanced directives or legal documents but ultimately patient's autonomy should be respected whenever possible unless they are deemed incapable of making decisions and a surrogate decision-maker has been appointed or there are legal constraints.

In cases where a patient's best interests conflict with their family's wishes, healthcare professionals must prioritize the patient's autonomy while also considering ethical principles like beneficence and non-maleficence. Open communication, education, and mediation can help navigate disagreements. Legal guidance may be sought, and documentation of discussions is crucial. Ultimately, decisions should be made in the patient's best interests, with respect for their autonomy and wishes.

One may consider studying the situation in all possible aspects before rushing into any sudden action or conclusion. This way the action-bias may be reduced somewhat drastically.

As long as the patient is in their 'right mind' it is ultimately their body, their choice. I ask myself just because we can do something should we? At what point do we consider quality of life versus quantity. Is financial ruin to delay the inevitable fully understood? Having hard conversations is a part of Advocacy, have them early in the process. At the end of the day we are patient, not family & friend advocates.

Es evidente que el paciente tiene todo el derecho a tomar decisiones que competen sobre su vida, como todos tenemos derecho a nuestro propio desarrollo y felicidad. Pero, consideramos necesario, que el paciente exprese de manera detallada, sus pedidos ante las posibles de necesidades de intervención y continuación del tratamiento. Mientras el Paciente esté lúcido, los familiares coadyuban al cuidado que realiza el persona médico, pero con respecto a las decisiones médicas se toman en base a los lineamientos que dejó el paciente.

When a patient's family opposes a treatment, especially concerning minors or those unable to decide for themselves, ethical considerations heighten. While acknowledging the complexity of treatment decisions, particularly when personal beliefs are involved, prioritizing the patient's best interests is crucial. In cases involving minors, where parental beliefs clash with necessary treatment, ethical principles dictate advocating for the child's welfare above all else. Decisions must be rooted in objective medical evidence and align with the patient's health and well-being, even if it means confronting familial preferences. Safeguarding the patient's health and ensuring access to appropriate care must prevail in such delicate situations.

If patient is adult, sound minded and competent to think then his/her interest must be considered, avoiding family wishes. Patient's best interest could avoid complications not family wishes.

Understand the Conflict: Talk to both the patient and the family privately to understand their perspectives. Why do the family wishes differ? Are there cultural or religious factors involved? Is there a lack of understanding about the patient's condition or treatment options? Facilitate Communication: Encourage open communication between the patient and their family. Can you help them have a mediated conversation where everyone feels heard?

En primer lugar, tanto el paciente como la familia, deben estar debidamente informados sobre todas las opciones disponibles para su tratamiento, y sus consecuencias. Partiendo de esa base se puede identificar a qué llamamos "mejores intereses", ya que la falta de información puede llevar a tomar decisiones erradas. Una vez ello, es el paciente quien puede decidir sobre sus intereses, considerando a una persona mayor de edad y con capacidades cognitivas plenas, ya que los deseos de la familia, pueden estar sesgados por el dolor y la negación de una posible pérdida.

Punto 4, en la medida en que es conciliable con punto 1. En el tema económico la autonomía debe ser total. Pero en el rtema de salud, la familia está implicada.