Capacity and Surrogacy

Medicine

was paternalistic- concerned about pt well being, not autonomy.

Surrogate

a person who participates in decision making and speaks to pts medical wishes, values, and commitments.

Medicine

was paternalistic- concerned about pt well being, not autonomy.

Surrogate

a person who participates in decision making and speaks to pts medical wishes, values, and commitments.

Risk relativity

- higher stakes of decision, greater degree of abilities needed.

paternalistic

Medicine was - concerned about pt well being, not autonomy

anti-paternalistic

medicine became ____- try to maximize well being within constraints of pt’s autonomy

Decision-making capacity

- __ - present regarding a particular set of options if and only if they have the ability to understand the relative info (knowing objective facts from 3rd person POV), appreciate the situation (how the facts apply to their own life, 1st person POV), reason about their options, and communicate their choice

authority

when a person’s choice determines which option is carried out

capacity, competency

___ determined by physician, ____ determined by judge

Legal guardian, health care power of attorney, psychiatric advance directive proxy, next of kin

4 ways to legally name a surrogate

What should surrogate keep in mind when participating in the shared decision making process on behalf of the patient?

the decisions should be made based on the patient's previously expressed wishes or substituted judgment and at least in their best interest