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Making Medical Decisions for Incapacitated Patients Without Proxies: Part II
In the United States, there is no consensus about who should make decisions in acute but non-emergent situations for incapacitated patients who lack surrogates. For more than a decade, our academic medical center has utilized community volunteers from the hospital ethics committee to engage in share...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Netherlands
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223299/ https://www.ncbi.nlm.nih.gov/pubmed/31691879 http://dx.doi.org/10.1007/s10730-019-09388-2 |
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author | Blackstone, Eric Daly, Barbara J. Griggins, Cynthia |
author_facet | Blackstone, Eric Daly, Barbara J. Griggins, Cynthia |
author_sort | Blackstone, Eric |
collection | PubMed |
description | In the United States, there is no consensus about who should make decisions in acute but non-emergent situations for incapacitated patients who lack surrogates. For more than a decade, our academic medical center has utilized community volunteers from the hospital ethics committee to engage in shared decision-making with the medical providers for these patients. In order to add a different point of view and minimize conflict of interest, the volunteers are non-clinicians who are not employed by the hospital. Using case examples and interviews with the community members, this paper describes how the protocol has translated into practice over the years since its inception. Members reported comfort with the role as well as satisfaction with the thoroughness of their discussions with the medical team. They acknowledged feelings of moral uncertainty, but expressed confidence in the process. Questions raised by the experience are discussed. Overall, the protocol has provided oversight, transparency, and protection from conflict of interest to the decision-making process for this vulnerable patient population. |
format | Online Article Text |
id | pubmed-7223299 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-72232992020-05-15 Making Medical Decisions for Incapacitated Patients Without Proxies: Part II Blackstone, Eric Daly, Barbara J. Griggins, Cynthia HEC Forum Article In the United States, there is no consensus about who should make decisions in acute but non-emergent situations for incapacitated patients who lack surrogates. For more than a decade, our academic medical center has utilized community volunteers from the hospital ethics committee to engage in shared decision-making with the medical providers for these patients. In order to add a different point of view and minimize conflict of interest, the volunteers are non-clinicians who are not employed by the hospital. Using case examples and interviews with the community members, this paper describes how the protocol has translated into practice over the years since its inception. Members reported comfort with the role as well as satisfaction with the thoroughness of their discussions with the medical team. They acknowledged feelings of moral uncertainty, but expressed confidence in the process. Questions raised by the experience are discussed. Overall, the protocol has provided oversight, transparency, and protection from conflict of interest to the decision-making process for this vulnerable patient population. Springer Netherlands 2019-11-06 2020 /pmc/articles/PMC7223299/ /pubmed/31691879 http://dx.doi.org/10.1007/s10730-019-09388-2 Text en © Springer Nature B.V. 2019 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Article Blackstone, Eric Daly, Barbara J. Griggins, Cynthia Making Medical Decisions for Incapacitated Patients Without Proxies: Part II |
title | Making Medical Decisions for Incapacitated Patients Without Proxies: Part II |
title_full | Making Medical Decisions for Incapacitated Patients Without Proxies: Part II |
title_fullStr | Making Medical Decisions for Incapacitated Patients Without Proxies: Part II |
title_full_unstemmed | Making Medical Decisions for Incapacitated Patients Without Proxies: Part II |
title_short | Making Medical Decisions for Incapacitated Patients Without Proxies: Part II |
title_sort | making medical decisions for incapacitated patients without proxies: part ii |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223299/ https://www.ncbi.nlm.nih.gov/pubmed/31691879 http://dx.doi.org/10.1007/s10730-019-09388-2 |
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