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Healthcare Surrogate

Healthcare Surrogate Selection/Informed Consent

Who should serve as surrogate? * Decisions are usually made best by consensus, instead of giving a surrogate unilateral power..... *BUT keep a hierarchy in mind for who should have say over others
COURT APPOINTED GUARDIANS ? * Have legal priority over other potential surrogates.... *Comes into play when patient has been declared incompetent, & the court appoints a guardian.... * Should be last resort if disputes arise and common ground can't be made
SURROGATES SELECTED BY PATIENTS ? * Aka – “Medical Power of Attorney” given to whomever the patient says it goes to
If there is no court appointed surrogate or a living will ? * decision is left on family member(s)
Family Selection Hierarchy for decision making ? *In this Order: --Court appointed guardian --Spouse --Adult Children of the patient --Parent of the patient --Adult sibling of the patient --Adult grandchildren of the patient --Close friend of the patient
Legal Issues ? * states have surrogate hierarchy---separated from spouse or even divorced---sometimes pt selects someone, but didn't document it
Healthcare Surrogates ? * A person chosen by a physician or an advanced practice nurse to make decisions for an individual who did not name a medical power of attorney representative and who is unable to make decisions for him or herself
Some criteria that should be considered when determining who is best qualified to serve as a patient’s surrogate ? * person has pts best interest in mind....* person has regular contact with pt, prior/during illness... * person cares for pt.... * able to have face-to-face talk with Dr (unless super far away or decision is needed ASAP)
Some Problems with SURROGATE DECISION MAKING ? * The physician should serve as the patient’s advocate if the surrogate’s decision conflicts with previous statements or best interests ---- * emotional issues (can't pull plug) --- * Conflicts of interest (like inheritance)
IMPROVING SURROGATE DECISION MAKING ? * discuss and have family meetings to talk about the process --- * can give recommendation based on pts status to the family --- * consult other medical staff
Created by: thamrick800