Surrogate decision-makers and advance directives

The patient’s husband is her legal next of kin and the person with surrogate decision-making authority. When the living will was discussed with him, he insisted that the patient had not intended for the document to be used in a situation like the present one. Further discussion with him revealed that he understood that the patient would not be able to recover any meaningful brain function but he argued that the living will did not apply because her condition was not imminently terminal. He further indicated that he did not consider his wife to be in a permanent unconscious condition.  The immediate family members (the couple’s adult children) disagreed with their father’s refusal to withdraw life support.

The treatment team allowed a week to pass to allow the husband more time to be supported in his grief and to appreciate the gravity of his wife’s situation.  Nevertheless, at the end of this time, the husband was unwilling to authorize withdrawal of life support measures consistent with the patient’s wishes as expressed in her living will.

List and discuss the three most important ethical/legal issues in this scenario [Just three]. Why are they legal /ethical issues?  Be sure and define the concepts you discuss. As a health care provider, how would you have handled this situation and why?