What They Don’t Say: Non-verbal Patient Behavior and its Role in Medical Decision Making

Presenter: Ralf J. Jox, M.D., Ph.D Associate Professor of Geriatric Palliative Care at Lausanne University Hospital, Switzerland, and Assistant Professor for Medical Ethics at the University of Munich, Germany
Recorded: October 17, 2017
Series: Curtis R. Holzgang, M.D., MACP Visiting Scholar
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Patients who lack decision-making capacity may display non-verbal behavior that challenges proxy decision making. This is particularly the case for patients with neuropsychiatric disorders such as dementia, who may refuse eating or nursing care by their gestures or may appear to express a will to live. Such behavior, however, is not only difficult to interpret but also hard to reconcile with standard ethico-legal criteria such as living wills or substituted judgment. In this talk, the distinguishing differences of non-verbal behavior, their meaning, and consideration in decision making will be analyzed.