Abstract
Loss of decision-making capacity can pose challenges for individuals, their families, and clinicians. Absence of advance directives and knowledge of patient’s treatment preferences can make health care delivery challenging, especially in complex medical situations that demand critical decision-making. Surrogate decision-making, wherein a substitute decision-maker is appointed to make decisions on the individual’s behalf when they are not able to do so, is helpful in such situations. Over the years, the concept of surrogate decision-making has evolved and is now a legal process with each state entitled to formulate its own surrogacy laws. This chapter covers the standards of surrogate decision-making, state-specific laws in the United States and their variability, applicability and limitations, status of non-traditional surrogates, and issues concerning the unbefriended.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
https://www.census.gov/prod/2010pubs/p25-1138.pdf. Accessed 17 Nov 2018.
Yadav KN, Gabler NB. Approximately one in three US adults completes any type of advance directive for end-of-life care. Health Aff. 2017;36(7):1244.
Del. Code. Ann., tit. 16 § 2507(b)(2)(e); Ga. Code Ann. § 31-9-2(a)(6)(E); 755 Ill. Comp. Stat. 40/25(a)(6); Me. Rev. Stat., tit. 18A§ 5-805(b)(5); Pa. Stat. Ann., tit. 20 § 5461(d)(1)(v); S.C. Code Ann. § 44-66-30(A)(6); S.D. Codified Laws § 34-12C-3(5); Utah Code Ann.§ 75-2a-108(1)(b)(ii)(D);Wis. Stat. Ann. § 50.06(3)(f); Wyo. Stat. §35-22-406(b)(vi).
Del. Code. Ann., tit. 16 § 2507(b)(2)(f); Ga. Code Ann. § 31-9-2(a)(6)(F); Me. Rev. Stat., tit. 18A § 5-805(b)(6); S.D. Codified Laws § 34-12C-3(6).
Ga. Code Ann. § 31-9-2(a)(6)(F); Me. Rev. Stat., tit. 18A §5-805(b)(7); S.D. Codified Laws § 34-12C-3(6).
Ga. Code Ann. § 31-9-2(a)(6)(D); N.M. Stat. Ann. §24-7A-5(B)(6); S.C. Code Ann. § 44-66-30(A)(6); S.D. Codified Laws § 34-12C-3(5); Utah Code Ann. § 75-2a-108(1)(b)(ii)(F); Wis.Stat. Ann. § 50.06(3)(e); Wyo. Stat. § 35-22-406(b)(iv).
S.D. Codified Laws § 34-12C-3(6).
Del. Code § 2507(b)(9).
Maryland Code, Health-Gen. § 5-605(b).
Tenn. Code Ann. § 68-11-1806(c).
W. Va. Code, § 16-30-8(b).
Tenn. Code Ann. § 68-11-1806(c)(3).
Hawaii Rev. Stat. §572-C-.
Colo. Rev. Stat. Ann. § 15-18.5-103(3).
Alaska Stat. § 47.24.016(a)(6); Ark. Rev. Stat. § 36-3231(A)(6); Del. Code Ann., tit. 16 § 2507(b)(3); Fla. Stat. Ann. § 765.401(1)(g); W. Va. Code § 16-30-8(a)(6).
Castillo LS, Williams BA, Hooper SM, Sabatino CP, Weithorn LA, Sudore RL. Lost in translation: the unintended consequences of advance directive law on clinical care. Ann Intern Med. 2011;154(2):121–8.
Karp N, Wood E. Incapacitated and alone: medical decision-making for the unbefriended elderly. Washington, DC: American Bar Association Commission on Law and Aging; 2003.
Cal. prob. code § 3208 (west 2016); Fla. prob. rule 5.900 (2017); O.C.G.A § 31-36a-7 (2016) (placement only); Ind. code § 16-36-1-8 (2016); N.J ct. rule 4:86-12 (2016) (special medical guardian); S.D. codified laws. § 34-12c-4 (2016); VA code ann. § 37.2-1101(b) (west2016), amended by s.b. 371, 2012 gen. assemb., reg. sess. (va. 2012).
Farrell TW, Widera E, Rosenberg L, Rubin CD, Naik AD, Braun U, et al. AGS position statement: making medical treatment decisions for unbefriended older adults. J Am Geriatr Soc. 2017;65:14–5.
Meisel A, Cerminara KL. The right to die: the law of end-of-life decision making. 3rd ed. New York: Aspen Publishers; 2004. p. 4.02(B)–3(B).
Bailey S. Decision making in health care: limitations of the substituted judgment principle. Nurs Ethics. 2002;9(5):483–9.
Dresser R. Precommitment: a misguided strategy for securing death with dignity. Tex Law Rev. 2003;81(7):1823–47.
Welie JV. Living wills and substituted judgments: a critical analysis. Med Health Care Philos. 2001;4(2):169–83.
Danis M, Garrett J, Harris R, Patrick DL. Stability of choices about life-sustaining treatments. Ann Intern Med. 1994;120(7):567–73.
Weissman JS, Haas JS, Fowler FJ Jr, et al. The stability of preferences for life-sustaining care among persons with AIDS in the Boston Health Study. Med Decis Making. 1999;19(1):16.
Shalowitz DI, Garrett-Mayer E, Wendler D. The accuracy of surrogate decision makers: a systematic review. Arch Intern Med. 2006;166(5):493–7.
Fagerlin A, Ditto PH, Danks JH, Houts RM. Projection in surrogate decisions about life-sustaining medical treatments. Health Psychol. 2001;20(3):166–75.
Hickman RL Jr, Pignatiello GA, Tahir S. Evaluation of the decisional fatigue scale among surrogate decision makers of the critically ill. West J Nurs Res. 2018;40(2):191–208.
Kopelman LM. The best interests standard for incompetent or incapacitated persons of all ages. J Law Med Ethics. 2007;35:187–96.
Vladeck BC, Westphal E. Dignity-driven decision making: a compelling strategy for improving care for people with advanced illness. Health Aff. 2012;31(6):1269–76.
DC Code § 21-2210.
Ala. Code § 22-8A-11(a)(2); Del. Code. tit. 16 § 2507(b)(6); Iowa Code Ann. § 144A.7(1); Me. Rev.Stat. tit. 18-A § 5-805(a); Mont. Code Ann. § 50-9-106(1)(a); Nev.Rev. Stat. § 449.626(1)(a); N.C. Gen. Stat. § 90-322(a)(1a); Ohio Rev.Code § 2133.08(D)(2).
Ohio Rev. Code Ann. § 2133.09.
Seiger CE, Arnold JF, Ahronheim JC. Refusing artificial and hydration: does statutory law send the wrong message? J Am Geriatr Soc. 2002;50(3):544–50.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Dhar, R., Gupta, A. (2019). Surrogate Decision-Making. In: Balasubramaniam, M., Gupta, A., Tampi, R. (eds) Psychiatric Ethics in Late-Life Patients. Springer, Cham. https://doi.org/10.1007/978-3-030-15172-0_9
Download citation
DOI: https://doi.org/10.1007/978-3-030-15172-0_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-15171-3
Online ISBN: 978-3-030-15172-0
eBook Packages: MedicineMedicine (R0)