Healthcare Surrogate Selection/Informed Consent
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| 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
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| 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
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| SURROGATES SELECTED BY PATIENTS ? | * Aka – “Medical Power of Attorney” given to whomever the patient says it goes to
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| If there is no court appointed surrogate or a living will ? | * decision is left on family member(s)
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| 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
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| Legal Issues ? | * states have surrogate hierarchy---separated from spouse or even divorced---sometimes pt selects someone, but didn't document it
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| 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
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| 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)
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| 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)
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| 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
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Created by:
thamrick800
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