scholarly journals Surviving Surrogate Decision-Making: What Helps and Hampers the Experience of Making Medical Decisions for Others

2007 ◽  
Vol 22 (9) ◽  
pp. 1274-1279 ◽  
Author(s):  
Elizabeth K. Vig ◽  
Helene Starks ◽  
Janelle S. Taylor ◽  
Elizabeth K. Hopley ◽  
Kelly Fryer-Edwards
Keyword(s):  
Decision Making ◽  
Surrogate Decision Making ◽  
Medical Decisions ◽  
Surrogate Decision ◽  
Decisions For Others

Surrogate decision making for unrepresented patients: Proposing a harm reduction interpretation of the best interest standard

2020 ◽  
Vol 15 (2) ◽  
pp. 57-64
Author(s):  
Phoebe Friesen ◽  
Nada Gligorov
Keyword(s):  
Decision Making ◽  
Harm Reduction ◽  
Well Being ◽  
The United States ◽  
Alternative Interpretation ◽  
Surrogate Decision Making ◽  
Best Interest ◽  
Medical Decisions ◽  
Best Interest Standard ◽  
Surrogate Decision

Unrepresented patients are individuals who lack decision makingcapacity and have no family or friends to make medical decisions for them. This population is growing in number in the United States, particularly within emergency and intensive care settings. While some bioethical discussion has taken place in response to the question of who ought to make decisions for these patients, the issue of how surrogate medical decisions ought to be made for this population remains unexplored. In this paper, we argue that standard applications of surrogate decision making principles in health care are not well suited to many unrepresented patients with long-term mental health diagnosis. We argue that when applied to this population, the substituted judgment standard, designed to preserve patient preferences and values, may lead to the exclusion of their preferences. We argue further that the application of the best interest standard runs the risk of leading to harmful cases of overtreatment or undertreatment. We offer an alternative interpretation of the best interest principle that is better able to promote the well-being of unrepresented patients, especially for those who lack capacity because of mental disorders. This alternative is based on the practices and principles of harm reduction and includes three components: emphasis on considering the expressed preferences of unrepresented patients, a focus on reducing harm as well as the delivery of clinical benefits, and a recognition of the importance of promoting trust.

Indiana Medical Resident’s Knowledge of Surrogate Decision Making Laws

2021 ◽  
pp. 0272684X2110047
Author(s):  
Stephanie Bartlett ◽  
Lyle P. Fettig ◽  
Peter H. Baenziger ◽  
Eliana N. DiOrio ◽  
Kayla M. Herget ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Treatment Options ◽  
Family Members ◽  
Veterans Affairs ◽  
Medical Residents ◽  
Surrogate Decision Making ◽  
Medical Decisions ◽  
Surrogate Decision ◽  
Va Hospitals

Introduction During the care of incapacitated patients, physicians, and medical residents discuss treatment options and gain consent to treat through healthcare surrogates. The purpose of this study is to ascertain medical residents’ knowledge of healthcare consent laws, application during clinical practice, and appraise the education residents received regarding surrogate decision making laws. Methods Beginning in February of 2018, 35 of 113 medical residents working with patients within Indiana completed a survey. The survey explored medical residents’ knowledge of health care surrogate consent laws utilized in Indiana hospitals and Veterans Affairs (VA) hospitals via clinical vignettes. Results Only 22.9% of medical residents knew the default state law in Indiana did not have a hierarchy for settling disputes among surrogates. Medical residents correctly identified which family members could participate in medical decisions 86% of the time. Under the Veterans Affairs surrogate law, medical residents correctly identified appropriate family members or friends 50% of the time and incorrectly acknowledged the chief decision makers during a dispute 30% of the time. All medical residents report only having little or some knowledge of surrogate decision making laws with only 43% having remembered receiving surrogate decision making training during their residency. Conclusions These findings demonstrate that medical residents lack understanding of surrogate decision making laws. In order to ensure medical decisions are made by the appropriate surrogates and patient autonomy is upheld, an educational intervention is required to train medical residents about surrogate decision making laws and how they are used in clinical practice.

Considering a family systems approach to surrogate decision-making.

2017 ◽  
Vol 35 (1) ◽  
pp. 85-87
Author(s):  
Elizabeth K. Vig ◽  
Janelle S. Taylor ◽  
Ann M. O'Hare
Keyword(s):  
Decision Making ◽  
Family Systems ◽  
Systems Approach ◽  
Surrogate Decision Making ◽  
Surrogate Decision

scholarly journals Religion and Spirituality in Surrogate Decision Making for Hospitalized Older Adults

2015 ◽  
Vol 55 (3) ◽  
pp. 765-777 ◽  
Author(s):  
Kristin N. Geros-Willfond ◽  
Steven S. Ivy ◽  
Kianna Montz ◽  
Sara E. Bohan ◽  
Alexia M. Torke
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Surrogate Decision Making ◽  
Religion And Spirituality ◽  
Hospitalized Older Adults ◽  
Surrogate Decision

scholarly journals A Scenario-Based Investigation of Surrogate Decision Making for Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 703-703
Author(s):  
Yuxin Zhao ◽  
Benjamin Katz ◽  
Pamela Teaster
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Financial Management ◽  
Self Efficacy ◽  
Decision Makers ◽  
Surrogate Decision Making ◽  
Insurance Company ◽  
Surrogate Decision ◽  
Critically Ill Adults ◽  
Amazon's Mechanical Turk

Abstract Surrogate decisions involve complex, challenging choices; surrogate decision-makers make treatment decisions for approximately 40% of hospitalized adults and 70% of older adults, and up to 95% of critically ill adults of any age. The purpose of our study was to understand how people make decisions for others and how surrogate decision making is linked to people’s cognition, self-efficacy, and demographics, especially differences in acute (e.g., health and medical care, financial management, and end of life) versus general scenarios (spending time with family, contacting an insurance company on behalf of a family member). Participants were recruited through Amazon’s Mechanical Turk. We collected data from 290 adult participants aged 18 years or older. On average, people reported a higher level of confidence in general versus acute scenario. The differences of confidence in scenario-based surrogate decision-making links to decision-makers’ cognition, self-efficacy, the experience of decision-making, the experience of caregiving, and demographic factors.

Supporting Life through Tube Feeding: Factors Influencing Surrogate Decision-Making

1993 ◽  
Vol 12 (3) ◽  
pp. 298-310 ◽  
Author(s):  
Donna Wilson
Keyword(s):  
Decision Making ◽  
Tube Feeding ◽  
Surrogate Decision Making ◽  
Grand Nombre ◽  
Factors Influencing ◽  
Etude De Cas ◽  
Étude De Cas ◽  
Surrogate Decision ◽  
Professionnels De La Santé

RÉSUMÉUn grand nombre de personnes ont besoin d'une sonde au cours de la dernière étape de leur vie. Par ailleurs, la décision du maintien des fonctions vitales revient souvent à une autre partie. Lorsque les membres d'une famille sont tenus de prendre cette décision pour un patient incompétent, quels facteurs influenceront leur choix? Une étude de cas et un sondage ethnométhodologique ont révélé clairement et en détail les facteurs ayant influencé une femme devant décider si les fonctions vitales de sa mére en état d'incapacité totale et de grave débilité devaient être maintenues au moyen d'une sonde pour gavage. La décision était difficile à prendre et survenait à un moment critique. Malheureusement, les facteurs ayant eu la plus forte influence furent les suivants: a) le besoin pressant d'une décision en raison d'un décès imminent; b) une lacune quant à la connaissance des valeurs et des préférences de la mère au sujet du maintien de ses fonctions vitales au moyen d'une sonde pour gavage; c) un manque de connaissance quant à la réalité de l'alimentation par sonde; et d) la croyance que cette mesure ne prolongerait pas la vie ni la souffrance de la mère. De plus, neuf autres facteurs, moins importants, ont été déterminés. Cette étude est principalement axée sur l'amélioration de la sensibilité des professionnels de la santé vis-à-vis de l'angoisse qu'éprouvent les gens à décider de maintenir les fonctions vitales d'un proche et du mode de décision en tant que tel.

Sign in / Sign up

Export Citation Format

Share Document