A surrogate decision maker, also known as a health care proxy or as agents, is an advocate for incompetent patients.
[1] At the 1991 Annual Meeting of the American Medical Association, the AMA adopted the report of the Council on Ethical and Judicial Affairs known as, "Decisions to Forgo Life-Sustaining Treatment for Incompetent Patients."
The recommendations of the report were the basis for amendments to Opinion 2.20 known as, "Withholding or Withdrawing Life-Sustaining Medical Treatment."
In addition, the council recognizes that there is a spectrum of decision-making capacity ranging from immaturity, to mental illness, to serious brain damage, and that health care decisions often must be made for individuals with diminished decisional faculties over extended periods of time.
The council offers the following report to expand on its previous guidelines and to identify features related to a meaningful and effective physician-proxy relationship.
The report begins by defining a number of terms related to health care directives before presenting theoretical frameworks used in making decisions for incompetent patients.
[1] A study was conducted aiming to describe physicians' experiences with surrogate communication and decision making for hospitalized adults.
The client's inclinations must be clearly written, and the health care agent should fully understand the instructions given as well as how to execute them.
The document should clearly state that the agent's authority begins only when the patent is unable to make health care decisions.
The advance directive should be reviewed regularly and reflect changes in the client's current marital situation (e.g. marriage or divorce).
A patient must meet a certain set of criteria prior to the legal selection of a health care surrogate agent.
[11] In the US, hierarchy of health care surrogates may vary according to the law of the specific state, but an example order of priority is listed here: When there are multiple candidates at the same level of priority in the hierarchal structure, it becomes their duty to reach an agreement in regard to decisions and care of the patient.
Any health care surrogate agent is granted the same rights in regard to access of medical information and decision-making as would the alert and competent patient.
These rights remain until such time as the client regains decisional capacity, a guardian is appointed, or the patient's death occurs.
[1][17] Occasionally, there is simply no information available about this patient's wishes and a "reasonable person" or best interest standard is applied by the hospital care team.
The wife believes that the care team should take her husband off life support and allow him to die.
Some states have passed laws allowing incompetent patients with certified mental illness to speak for themselves regarding decision-making.
Current statutory solutions include living wills or advance directives that explain the patient's wishes in certain medical situations.
The patient self-determination act states that hospitals and health care facilities must provide information about advance directives and DPA/HC.
Also, a proxy or surrogate decision-maker can provide these final wishes to the doctor or care team if a DPA/HC or AD is not present.
Some fictional assumptions underlying judicial decisions include the following misconceptions:[citation needed] 1.
Most people don't want to drain their family's funds to keep them alive especially when they are in a persistent vegetative state with no possible chance for recovery.
In these cases, it is often weighing the risks and benefits of keeping the patient breathing, when they are clearly not living their life to its full potential.