scholarly journals The Ethics of Choosing a Surrogate Decision Maker When Equal-Priority Surrogates Disagree

2021 ◽  
Author(s):  
Matthew Shea
Keyword(s):  
Decision Maker ◽  
Surrogate Decision Maker ◽  
Surrogate Decision

Psychiatric Advance Directives

2003 ◽  
Vol 9 (2) ◽  
pp. 55-59 ◽  
Author(s):  
Paula K. Vuckovich
Keyword(s):  
Health Care ◽  
Decision Maker ◽  
Advance Directives ◽  
Care Provider ◽  
Mentally Ill ◽  
Autonomous Control ◽  
Surrogate Decision Maker ◽  
Psychiatric Advance Directives ◽  
Mentally Ill Persons ◽  
Surrogate Decision

Psychiatric advance directives (PADs) have been legally defined in 12 states and implemented in all but 9. PADs may prevent unwanted treatment and identify preferred treatment. They may also allow mentally ill persons to exercise autonomous control over care even during periods of illness-induced incompetence. PADs can be beneficial for intermittently psychotic patients who have a trusted health care provider and a surrogate decision maker. Because of the growing interest in the use of PADs, nurses should be informed about the intended purposes, benefits, and drawbacks of them.

scholarly journals POLST Signature Requirements: Responding With Compassion While Ensuring Informed Consent

2020 ◽  
pp. 104990912095308
Author(s):  
Robert Macauley ◽  
Susan Tolle
Keyword(s):  
Health Care ◽  
Informed Consent ◽  
Decision Maker ◽  
Health Care Professional ◽  
Patient Autonomy ◽  
Necessary Condition ◽  
Surrogate Decision Maker ◽  
Decisional Capacity ◽  
Spiritual Distress ◽  
Surrogate Decision

The majority of states require the signature of a surrogate decision maker on a POLST form for a patient who lacks decisional capacity. While commendable in its intention to ensure informed consent, in some cases this may lead the surrogate to feel that they are signing their loved one’s “death warrant,” adding to their emotional and spiritual distress. In this paper we argue that such a signature should be recommended rather than required, as it is neither a sufficient nor necessary condition of informed consent. Additional steps—such as requiring the attestation and documentation of the signing health care professional that verbal consent was fully informed and voluntary—can achieve the ultimate goal of respecting patient autonomy without adding to the surrogate’s burden.

scholarly journals INFORMED CONSENT IN CLINICAL TRIALS FOR PERSONS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S28-S28 ◽  
Author(s):  
Joan G Carpenter
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Clinical Trials ◽  
Informed Consent ◽  
Nursing Homes ◽  
Decision Maker ◽  
Surrogate Decision Maker ◽  
Decision Making Capacity ◽  
Consent Document ◽  
Surrogate Decision

Abstract Informed consent is one of the most important processes during the implementation of a clinical trial; special attention must be given to meeting the needs of persons with dementia in nursing homes who have impaired decision making capacity. We overcame several challenges during enrollment and consent of potential participants in a pilot clinical trial including: (1) the consent document was designed for legally authorized representatives however some potential participants were capable of making their own decisions; (2) the written document was lengthy yet all seven pages were required by the IRB; (3) the required legal wording was difficult to understand and deterred potential participants; and (4) the primary mode of communication was via phone. We tailored assent and informed consent procedures to persons with dementia and their legally authorized representative/surrogate decision maker to avoid risking an incomplete trial and to improve generalizability of trial results to all persons with dementia.

Alignment in Surrogate Decision Maker Research Opinions: Adult vs Pediatric Intensive Care Patients

2020 ◽  
Vol 231 (4) ◽  
pp. e177
Author(s):  
Leslie Ann Sealey ◽  
Julia Raddatz ◽  
Nirav R. Shah ◽  
Kyle Cunningham ◽  
Jacqueline Morey ◽  
...  
Keyword(s):  
Intensive Care ◽  
Decision Maker ◽  
Pediatric Intensive Care ◽  
Surrogate Decision Maker ◽  
Intensive Care Patients ◽  
Surrogate Decision
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