Despite challenges of decision making for unrepresented patients, few laws or policy statements offer solutions. This article offers 5 key things to do.
Physicians, committees, and guardians all make decisions for unrepresented patients in the US. This article considers a “tiered” approach as an alternative.
When patients are unable to express their wishes and do not have surrogates or advance directives, which and whose values should inform decision making for them? We discuss ethical complexities of caring for unrepresented patients.
Ruth L. Ackah, MD, Rohini R. Sigireddi, and Bhamidipati V. R. Murthy, MD
Although undocumented immigrants contribute to the pool of available organs and to the US tax base, they are not eligible for organ transplantation in most US states.
A guardian’s request to sterilize a woman with intellectual disabilities is not ethically justifiable unless the woman assents and it is to her benefit.
Patrick S. Phelan, Mary C. Politi, PhD, and Christopher J. Dy, MD, MPH
During immediate and long-term recovery periods, decisions must account for patients’ personal goals and possible clinical outcomes and should clarify what recovery means.
William F. Parker, MD, MS and Marshall H. Chin, MD, MPH
Given organ scarcity, transplantation programs state that patient promises of compliance cannot be taken at face value, excluding candidates who are deemed untrustworthy.
Shared decision making is practically difficult to implement in mental health practice but remains an ethical ideal for motivating therapeutic capacity.