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According to Blais, Hayes, Kozier and Erb (2006), "Autonomy refers to the self-determination and the right to make one's own decisions." By applying this principle of autonomy, patient's decision must be respected even though their choices may not seem to be in the patient's best interest. The Patient Self Determination Act of 1991 mandates all healthcare institutions to complete an advanced directive such as a living will or a durable power of attorney upon the patient's request. What will happen if a patient without an advance directive is unable to express his or her own wishes due to cognitive function loss or persistent vegetative state (PVS)? The lack of legal documentation will eventually lead to an ethical dilemma...
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