Surrogate Decision Maker

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 More General Terms 4 Additional Terms 5 References

More Specific Terms

• durable power of attorney (DPoA)
• guardianship

Introduction

• A person designated to make decisions for a patient that has lost autonomy. This generally defaults to a family member, but is state specific. The spouse is nearly always the designated surrogate (if alive & competent). Next in line are generally children, parents, siblings, grandparent, grandchild.
  

• Ideally, a surrogate uses substituted judgment to infer from a patient's earlier statements or actions, what choices that person would now make if he/she was still able to express an autonomous decision.
  
• In practice, surrogates often guess incorrectly or substitute their own beliefs for those of the patient.
  
• The surrogate must act in the patient's best interest. The physician must serve as the patient advocate.
  
• No consensus among surrogates for or against physician recommendation regarding life support decisions for incapacitated patients; 42% of surrogates prefer no physician recommendations [2]

More General Terms

• medical ethics

Additional Terms

• autonomy
• competence
• substituted judgement

References

1. Kapp M & Finucane T. Decision Making, In: Comprehensive Geriatric Assessment, Osterweil et al eds, McGraw-Hill, New York, pg 595
2. White DB et al Are physicians' recommendations to limit life support beneficial or burdensome? Bringing empirical data to the debate. Am J Respir Crit Care Med 2009 Aug 15; 180:320. PMID: [1]

surrogate decision maker (proxy)