Commentary on End-of-Life Decision-Making in Singapore: Best Interest Conflicting with Surrogate Decision-Making

In patients who have impaired decision-making capacity, an appointed surrogate (extended autonomy) or the best interests standard are used to make medical decisions. When these standards are in conflict with each other, clinicians are left in a conundrum. The case of a patient in a persistent vegetative state is used to illustrate the relevant principles and the conflicts that can arise. It is reviewed through the commentary of a student of medicine, and the role of managing physicians in consensus-building is explored as a potential solution to this dilemma.