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  1. The Theory and Practice of Surrogate Decision‐Making.David Wendler - 2017 - Hastings Center Report 47 (1):29-31.
    When a patient lacks decision-making capacity and has not left a clear advance directive, there is now widespread agreement that patient-designated and next-of-kin surrogates should implement substituted judgment within a process of shared decision-making. Specifically, after discussing the “best scientific evidence available, as well as the patient's values, goals, and preferences” with the patient's clinicians, the patient-designated or next-of-kin surrogate should attempt to determine what decision the patient would have made in the circumstances. To the extent that this approach works, (...)
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  • Schrödinger’s Cat and the Ethically Untenable Act of Not Looking.Christian J. Vercler & Naomi Tricot Laventhal - 2020 - American Journal of Bioethics 20 (6):40-42.
    Volume 20, Issue 6, June 2020, Page 40-42.
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  • On Patient Well‐being and Professional Authority.Mildred Z. Solomon - 2017 - Hastings Center Report 47 (1):26-27.
    Two papers in this issue address the limits of surrogates’ authority when making life-and-death decisions for dying family members or friends. Using palliative sedation as an example, Jeffrey Berger offers a conceptual argument for bounding surrogate authority. Since freedom from pain is an essential interest, when imminently dying, cognitively incapacitated patients are in duress and their symptoms are not manageable in any other way, clinicians should be free to offer palliative sedation without surrogate consent, although assent should be sought and (...)
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  • A Good Death.Tia Powell & Adira Hulkower - 2017 - Hastings Center Report 47 (1):28-29.
    A good death is hard to find. Family members tell us that loved ones die in the wrong place—the hospital—and do not receive high-quality care at the end of life. This issue of the Hastings Center Report offers two articles from authors who strive to provide good end-of-life care and to prevent needless suffering. We agree with their goals, but we have substantial reservations about the approaches they recommend. Respect for the decisions of patients and their surrogates is a relatively (...)
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  • The Apnea Test: Requiring Consent for a Test That is a Self-Fulfilling Prophecy, Not Fit for Purpose, and Always Confounded?Ari R. Joffe - 2020 - American Journal of Bioethics 20 (6):42-44.
    Volume 20, Issue 6, June 2020, Page 42-44.
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  • Marginally Represented Patients and the Moral Authority of Surrogates.Jeffrey T. Berger - 2020 - American Journal of Bioethics 20 (2):44-48.
    Incapacitated adult patients are commonly divided into two groups for purposes of decision making; those with a surrogate and those without. Respectively, these groups are often referred to as represented and unrepresented, and the relative ethics of decision making between them raises two particular issues. The first issue involves the differential application of the best interests standard between groups. Second is the prevailing notion that representedness and unrepresentedness are categorical phenomena, though it is more aptly understood as a multidimensional and (...)
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  • Managing Conflicts between Physicians and Surrogates.Carol Bayley - 2017 - Hastings Center Report 47 (1):24-26.
    Two articles in this issue of the Hastings Center Report explore two sides of the same problematic coin. In “The Limits of Surrogates’ Moral Authority and Physician Professionalism,” Jeffrey Berger discusses the moral problem of a surrogate refusing a treatment, palliative sedation, on behalf of a patient whose suffering is refractory to intensive palliative efforts provided by a multidisciplinary team. In “After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation,” Ellen Robinson and her colleagues analyze data from a study (...)
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