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Who gets to decide for the older patient with a limited decision-making capacity: a review of surrogacy laws in the European Union

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Abstract

Family members of older incompetent patients are increasingly playing an essential role in the decision-making process relating to medical treatment. Furthermore, rights of patients and carers and the extent of their legal involvement vary widely across the European Union. Starting with an illustrative case within the Italian legal framework, this review focuses on statutory laws in the European Union to analyse the role and the rights of surrogates on behalf of older incompetent patients. The authors have identified two main essential areas of surrogate’s law in Europe, in the absence of the advance directives: the role of family members automatically accepted as surrogates by law and a legal representative appointed by a court.

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Authors and Affiliations

  1. Specialized Medicine Department, 3rd Medicine Ward, “A. Cardarelli” High Survey Hospital, Naples, Italy

    Loredana Tibullo & Anna Parisi

  2. Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain

    Antonio M. Esquinas

  3. Department of Neuroscience and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy

    Maria Vargas

  4. Cognitive Disorders and Dementia Unit, Local Agency for Health, Modena, Italy

    Andrea Fabbo

  5. Medicine Department, Geriatric and Intensive Geriatric Care, Hospital “San Giuseppe Moscati”, Avellino, Italy

    Filomena Micillo & Nicola Vargas

Authors
  1. Loredana Tibullo
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  2. Antonio M. Esquinas
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  3. Maria Vargas
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  4. Andrea Fabbo
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  5. Filomena Micillo
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  6. Anna Parisi
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  7. Nicola Vargas
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Contributions

Concept and design: NV; LT; Data collection: AP, AF; Analysis and interpretation of data: NV; Loredana Tibullo, MV; Manuscript writing and approval: NV, AE; Revision of Manuscript: NV; We would thank BB for the help in the revision of the manuscript and AG for the precious help in the revision of the English style.

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Correspondence to Loredana Tibullo.

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Tibullo, L., Esquinas, A.M., Vargas, M. et al. Who gets to decide for the older patient with a limited decision-making capacity: a review of surrogacy laws in the European Union. Eur Geriatr Med 9, 759–769 (2018). https://doi.org/10.1007/s41999-018-0121-8

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