Disability, Quality of Life, and Vitalism in End-of-Life Care

This article draws upon the work of disability bioethicists to offer additional reflections on how and why conflicts sometimes emerge between the surrogates of disabled patients and health care practitioners. The Best Interest Values (BIV) system described by Fiester can lead to, or coincide with, ableist attitudes that endanger the lives and dignity of disabled people. At the same time, her competing hierarchies could do a better job distinguishing quality of life concerns from vitalism, the latter of which does not well represent many disability advocates’ concerns regarding healthcare systems. The article concludes by arguing that acquiescing to surrogate demands and legal requirements to prolong the lives of disabled patients can lead to inhumane treatment plans that ought to be resisted by health care practitioners.