Articles Tagged With: decision-maker
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Surrogates View Their Role Differently Than Clinicians
Surrogates view their role as speaking on behalf of the patient; clinicians view the surrogate’s role as speaking as if the patient was in the room advocating for themselves. The problem arises when the surrogate does not voice the opinions of the patient, instead voicing their own opinion of the situation.
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Court-Appointed Guardians for Unrepresented Patients
Ethicists are seeing a range of issues arise during consults involving unrepresented patients, including conflicts over how aggressive treatment should be, whether to treat at all, how to discharge, and how to follow up with compliance with treatment. Creating a template for actions to take related to unrepresented persons who present to the hospital is a proactive first step.
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Ethics Knowledge Gaps Exist on Assessing Capacity, Identifying Surrogate Decision-Maker
Clinicians must determine if patients can understand the question, state a choice, appreciate the risks and benefits, and rationalize why their decision aligns with their care preferences. The fact that few participants understand decision-makers and surrogates carries important implications for the ethics field.
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Challenges with Surrogate Informed Consent
The central ethical question is whether a surrogate’s judgment for consenting or refusing a medical intervention on behalf of a patient is consistent and congruent with this patient’s preferences, interests, and values.
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Policies Support Clinicians if Asked to Provide Inappropriate Care
When a family demands possibly inappropriate life-sustaining interventions, clinicians often turn to hospital policies for guidance. The authors of a recent study examined the effectiveness of Yale New Haven Hospital’s Conscientious Practice Policy. A theme emerged, focused on the inconsistent use of the policy. Whether it was used depended mostly on how resistant the family was to limiting interventions.
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Surrogates’ Authority Varies on Mental Health Treatment Decision-Making
Ethicists should be familiar with their respective jurisdictions’ statutes and case law, especially those whose health systems cross state borders.
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Even the Best Ethics Consults Can Result in Dissatisfaction
It may boil down to disagreements among patients, families, and caregivers about what is best.