Policy on Surrogate Consent for Research — Excerpts

In a nonemergency room environment:

Surrogate consent may be obtained from any of the following potential surrogates who has reasonable knowledge of the subject, in the following descending order of priority:

1. The person’s agent designated by an advance health care directive.

2. The conservator or guardian of the person having the authority to make health care decisions for the person.

3. The spouse of the person.

4. The domestic partner of the person as defined in Section 297 of the Family Code

5. An adult son or daughter of the person.

6. A custodial parent of the person.

7. Any adult brother or sister of the person.

8. Any adult grandchild of the person.

9. An available adult relative with the closest degree of kinship to the person.

In nonemergency room settings:

No surrogate consent may be utilized if there is a disagreement whether to consent among the members of the highest available priority class of surrogates, (e.g., where two members of persons in the highest of categories 5 through 7 disagree and there is no person in categories 1 through 4 available.

The investigator is responsible for ensuring that the surrogate:

has reasonable knowledge of the subject;

is familiar with the subject’s degree of impairment;

is willing to serve as the substitute decision maker;

understands the risks, potential benefits, procedures, and available alternatives to research participation;

makes decisions based on the subject’s known preferences, and where the subject’s preferences are unknown, makes decisions based upon the surrogate’s judgment of what the subject’s preferences would be.

In both a nonemergency room and an emergency room setting:

• The surrogate shall complete the "Self-Certification of Surrogate Decision Makers for Participation in Research" form as an attachment to the informed consent document for the research study. (See sample form.)

• Surrogates are prohibited from receiving any financial compensation for providing consent. This does not prohibit the surrogate from being reimbursed for expenses the surrogate may incur related to the surrogate’s participation in the research.

Potential surrogates must be advised that if a higher-ranking surrogate is identified at any time, the investigator will defer to the higher-ranking surrogate’s decision regarding the subject’s participation in the research.

For nonemergency room environment research only, if the potential surrogate identifies a person of a higher degree of surrogacy, the investigator is responsible to contact such individuals to determine if they want to serve as surrogate.

Source: University of California Office of the President.