The bioethicist has a role, but ultimately, the doctor signs the orders and the hospital legal team will decide what the outcome is - if you want what actually occurs.
They are the actual ones calling the shots. But a bioethicist is not the final speaker on treatment at any time.
The treating doctor is not the final speaker either.
The patient is (or the parent on his behalf)
I will share my experience. My mother had been battling various forms of cancer for years. She had designated me to have power of attorney for medical purposes.
When she entered the hospital at one particular time the hospital staff badgered her repeatedly to sign a do not intubate ((DNI) /do not resuscitate (DNR) order. Being a woman who was extremely close to God, and having lived a life full of suffering and joy, she did not feel the Holy Spirit was calling her to give up the fight at that time.
It was her suffering and prayers to God that converted me after decades of mortal sin. The ER doctor went into her room and had a conversation which I witnessed. He said “You know how when we get older we don’t want to be a burden to our loved ones?” My mother said yes… Then the doctor said “You don’t want to be a burden to your children, do you?” My mother answered no…
He then went directly out to the nurse’s station and changed it to DNR DNI, without ever directly asking her if she wanted it changed. Again this followed 3 days of constant badgering to try to make her change her decision to DNR DNI to which she always responded that she wanted to be resuscitated.
After about an hour I realized what he had done. I discussed with my mom if she had changed her mind about being resuscitated… she had not. I had to go to the nurse’s station to change it back. They said she was now too sedated to make that decision. So I had to show them the power of attorney document to force them to comply with the expressed wishes of my mother.
Later when she slipped into a coma I had to “remind” the hospital staff to turn her O2 back on after it somehow was turned off (with a rest in peace note next to her bed).
You see her suffering was never in vain. It obtained my conversion back to God, and likely many others. During her last hospital stay she was able to do many wondrous things. She saw her guardian angels. She told me of the twin children my wife and I would have years later. She was able to correct my sibling in the sin he was holding on to, and she grew in trust of God’s mercy.
Eventually I had to make the decision to stop nutrition when her body/organs shut down and was not sustaining her but rather causing a burden. But I don’t know why people can not admit that the order to take away nutrition for Alfie 8+ months before his death was not wrong. The fact that he lived 8 months processing that nutrition says without a doubt it was the wrong call at that time.
