Surrogate decision making: reconciling ethical theory and clinical practice.

Full Abstract

The care of adult patients without decision-making abilities is a routine part of medical practice. Decisions for these patients are typically made by surrogates according to a process governed by a hierarchy of 3 distinct decision-making standards:
patients' known wishes, substituted judgments, and best interests. Although this framework offers some guidance, it does not readily incorporate many important considerations of patients and families and does not account for the ways in which many patients and surrogates prefer to make decisions. In this article, the authors review the research on surrogate decision making, compare it with normative standards, and offer ways in which the 2 can be reconciled for the patient's benefit.

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Author information

Author/s: Berger, Jeffrey T (JT); DeRenzo, Evan G (EG); Schwartz, Jack (J);

Affiliation: School of Medicine, State University of New York at Stony Brook, Stony Brook, New York, USA. jberger(-atsign-)winthrop.org

Journal and publication information

Publication Type: Journal Article

Journal: Annals of internal medicine (Ann Intern Med), published in United States. (Language: eng)

Reference: 2008-Jul; vol 149 (issue 1) : pp 48-53

Dates: Created 2008/07/01; Completed 2008/07/09;

PMID: 18591637, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Advance Directives
Caregivers - psychology
Decision Making - ethics
Family - psychology

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