title: The semblance of autonomy: treatment of persons with disabilities under the Uniform Health-Care Decisions Act.
abstract: This Article illuminates the dangers of the Uniform Health-Care Decisions Act, which provides a set of model rules designed to clarify and expedite end-of-life health-care decisionmaking for incapacitated patients. The uniform commissioners and many scholars who have commented on the Act have touted the legislation as a model for defending patient autonomy. As this Article will reveal, the impression of autonomy is an illusion. In fact, the Act privileges the perspectives of the able-bodied over those of persons with disabilities, endangers the autonomy of incapacitated patients, and empowers proxy decisionmakers who have incentives to terminate treatment. These risks have become all the more significant with the rise of managed-care programs that create pressures to minimize care. After highlighting the serious risks to vulnerable patients under the Uniform Health-Care Decisions Act, the Article offers alternative rules and stronger safeguards to better protect patient autonomy and defend against wrongful health-care decisions. This Article urges states seeking improved end-of-life health-care procedures to codify these or similar protections in order to avoid the lethal shortcomings of the Uniform Health-Care Decisions Act.
authors.affiliation: United States Court of Appeals for the Ninth Circuit.
authors.forename: Marah
authors.initials: M
authors.lastname: Stith
mesh_terms: D003657:Decision Making; D006233:Persons with Disabilities; D006801:Humans; D026684:Personal Autonomy; D013727:Terminal Care / Q000331:legislation & jurisprudence*; D014481:United States