Articles Tagged With: surrogates
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When Surrogate Decision-Makers Misunderstand Patients’ Condition
In the view of clinicians, surrogates of patients with higher acuity of illness could better understand the clinical situation. However, those surrogates might be less likely to correctly identify all the affected organ systems. Surrogates who seem to strongly grasp the situation may not actually feel as secure in their understanding.
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Spiritual Support Alleviates Anxiety of Surrogate Decision-Makers
Surrogates enrolled in an enhanced spiritual care model reported less anxiety, more spiritual well-being, and greater satisfaction with spiritual care compared to surrogates who received usual care. These results suggest expanded chaplain involvement is beneficial.
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Some ED Patients Undergo Unwanted End-of-Life Care
Despite uncertainty, it is possible to provide value-concordant care in the ED. Identify those patients, and initiate decisions based on goals of care, not just by a default reflexive pathway. This could help improve patients’ experiences and outcomes broadly, by targeting the right treatments to the right patients.
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Multiple Legal Issues with ED End-of-Life Care
An attorney argues missing the opportunity to respect autonomy in care decision-making for a patient who no longer desires curative care should be considered a poor outcome.
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Ethical Approaches for Accurate Patient-Reported Outcome Measures
When researchers are comparing treatments in clinical trials, proxy reports might be a useful surrogate for patients whose self-report cannot be obtained or is unreliable.
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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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Updated Guidance on Informed Consent in Stroke Management
A new position statement aims to help neurologists provide the highest quality patient care for ischemic stroke by providing ethical guidance on how to navigate the decision-making process for stroke patients who may struggle to provide consent.
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Neurology Groups Update Position on Stroke and Informed Consent
Experts provide updated ethical guidance on decision-making capacity, emergency treatment, and clinical research.
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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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Establishing the Right Policies on Decision-Making for Unrepresented ICU Patients
A new policy statement recommends institutions prevent patients from becoming unrepresented in the first place by offering advance care planning. Conduct thorough capacity assessments and search for potential surrogates before assuming patients are unrepresented.