A 72-year-old man with stage IV pancreatic cancer and progressive cognitive decline from brain metastases is admitted to the hospital with sepsis. He is currently alert but increasingly confused, with fluctuating mental status. Three days ago, during a period of clarity, he stated to his daughter, 'I don't want to be a vegetable on machines.' However, he now insists he wants 'everything done' to survive. His daughter, who holds his healthcare power of attorney and was previously designated as his healthcare proxy, requests a family meeting. She states that his current wishes contradict his previously expressed values and fears he is unable to make decisions due to acute delirium from infection. The attending physician must decide how to proceed with code status and escalation of care. Which of the following ethical and legal frameworks is most appropriate to guide this decision?

1. A)Autonomy—prioritize the patient's current stated wishes regardless of cognitive status
2. B)Beneficence—the physician should independently determine what treatments best serve the patient's medical interests
3. C)Substituted judgment—the surrogate should decide based on what the patient would choose if able to decide with full informationGABARITO
4. D)Non-maleficence—avoid aggressive interventions because they may cause harm
5. E)Best interest standard—the surrogate should choose what a reasonable person in the patient's condition would want