Ryan: Ethics
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| Court appointed guardians | Have legal priority over other surrogates
Happens when pt is incompetent
Sought as a last resort
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| Surrogates selected by Pt | Set up by living wills
Allows the pt to have autonomy
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| Family members | Most people want family members to serve as surrogates
Often know what the Pt would want
Many times, decisions are made as a group
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| WV selection hierarchy | 1.Court appointed guardian
2.Spouse 3.Adult children
4.Parent 5.Adult sibling
6.Adult grandchildren
7. Close friend
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| If pt selects someone, but hasn't completed a living will... | Should be respected as the pt chose them
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| Medical Power of Attorney | Person chosen by pt to make medical decisions
Representative's name should be written on MPOA form, witnessed by 2 people and notarized
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| Healthcare surrogates | Chosen by physician/adv. nurse to make decisions for pt who did not name a MPOA
Generally the person "best qualified"
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| Healthcare Surrogates Criteria | -Better able to make decisions according to the pt wishes
-Person's regular contact with pt
-Demonstrated care and concern
-Visit pt during illness
-engage in face-to-face contact
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| Problems with decision making | If surrogate's decision conflicts with previous statements or best interests
Emotional barriers
Decisions inconsistent with pt values
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| Problems with decision making (cont) | Conflicts of interest
-don't be overly suspicious
-respecting close relationships is important
Disagreements among potential surrogates
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| Improving surrogate decision making | After sufficient discussions, surrogates agree in decisions
Discuss decision-making process
Decisions should be made on the pt's preferences
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| Improving surrogate decision making (cont) | Give a recommendation
-based on what is known about the pt
-important when families are overwhelmed with grief
-can be a valuable tool
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Created by:
bcriss
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