RT Book, Section A1 Kapp, Marshall B. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Wood, Lawrence D.H. SR Print(0) ID 2291089 T1 Chapter 5. Legal Issues in Critical Care T2 Principles of Critical Care, 3e YR 2005 FD 2005 PB The McGraw-Hill Companies PP New York, NY SN 9780071416405 LK accesssurgery.mhmedical.com/content.aspx?aid=2291089 RD 2023/12/03 AB In order to be considered legally effective, consent to medical treatment must meet three tests: (1) it must be voluntary; (2) it must be adequately informed or knowing; and (3) it is given by an individual with adequate mental capacity and legal authority.Whereas a variety of state laws in the United States pertain to decisional capacity and surrogate decision making, in most cases the physician relies on family members as the surrogate decision makers for an incapacitated patient, even in the absence of a specific statute, advance directive, or court order empowering the family.An increasing percentage of patients, especially as the population ages, lack available, willing relatives or friends to act as surrogate decision makers. In such cases physicians should seek guidance from living wills or other forms of advance directives, when these exist.Neither a patient nor his or her family has a legal right to, nor does the physician have the obligation to provide, medical treatment that would be futile—that is, nonbeneficial—for that patient.As directors of critical care units, critical care physicians should participate in creating institutional protocols that delineate operational principles of the critical care team and the individual physician's supervisory responsibilities.