It is well documented that clinicians frequently cave-in to surrogate demands to continue non-beneficial treatment. What I had not focused on is a finding by sociologist Susan Shapiro .
Clinicians also accede to surrogate requests to stop life-sustaining treatment even when those surrogates lack legal authority to make such requests. Here is an excerpt from a summary of Shapiro's research:
Shapiro found many reasons why families were so rarely denied the option of withdrawing life support. Often, she said, “patients meet the requisite conditions of the law, or their medical condition is devastating—even if not precisely what is delineated in the law.” Additionally, Shapiro noted, “many physicians don’t know the law or don’t know the difference between a power of attorney and a default surrogate.” Finally, Shapiro found, “physicians don’t insist on seeing the advance directive document and follow whatever the family says is in the document,” nor will they stand in the way of the “wrenching decisions made by grieving families.”