An Ethical and Legal Framework for Physicians as Surrogate Decision‐Makers for Their Patients

Journal of Law, Medicine and Ethics 43 (4):857-877 (2015)

Abstract
In Western industrialized countries, it is well established that legally competent individuals may choose a surrogate healthcare decision-maker to represent their interests should they lose the capacity to do so themselves. There are few limitations on who they may select to fulfill this function. However, many jurisdictions place restrictions on or prohibit the patient's attending physician or other provider involved with an individual's care to serve in this role. Several authors have previously suggested that respect for the autonomy of patients requires that there be few constraints on whomever they may appoint as a proxy. In this essay we revisit this topic by first providing a survey of current state laws governing this activity. We then analyze the clinical and ethical circumstances in which potential difficulties could arise. We take a more nuanced and circumspect view of prior suggestions that patients should have virtually unfettered liberty to choose their healthcare proxies. We suggest a strategy to balance the freedom of patients' right to choose their surrogates with fiduciary duty of the state as regulator of medical practice. We identify six domains of possible concern with such relationships and suggest straightforward methods of mitigating their potential negative effects that could be plausibly be incorporated into physician practice.
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1111/jlme.12325
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

Our Archive


Upload a copy of this paper     Check publisher's policy     Papers currently archived: 38,984
Through your library

References found in this work BETA

No references found.

Add more references

Citations of this work BETA

No citations found.

Add more citations

Similar books and articles

Physician-Patient Relations: No More Models.Greg Clarke, Robert T. Hall & Greg Rosencrance - 2004 - American Journal of Bioethics 4 (2):16 – 19.
The Limits of Proxy Decision Making: Undertreatment.Muriel R. Gillick & Terri Fried - 1995 - Cambridge Quarterly of Healthcare Ethics 4 (2):172.
The Limits of Proxy Decision Making: Overtreatment.Terri R. Fried & Muriel R. Gillick - 1995 - Cambridge Quarterly of Healthcare Ethics 4 (4):524.

Analytics

Added to PP index
2015-12-29

Total views
32 ( #228,362 of 2,319,647 )

Recent downloads (6 months)
4 ( #344,140 of 2,319,647 )

How can I increase my downloads?

Monthly downloads

My notes

Sign in to use this feature