AMA Journal of Ethics

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.

The AMA Code of Medical Ethics discusses situations in which a surrogate is needed but not available to make health care decisions for a patient.

A look at current literature and work by a statewide initiative can motivate development of policies that help respond to unrepresented patients’ needs.

Responding to “Added Points of Concern about Caring for Dying Patients,” authors argue that physicians’ refusal to prescribe lethal drugs in accordance with states’ death with dignity laws could damage patient-physician relationships and harm patients.

Authors respond to “How Should Physicians Care for Dying Patients with Amyotrophic Lateral Sclerosis?” by arguing that patients’ motives for accessing death with dignity laws should be thoroughly explored and that temporarily limiting patient autonomy can promote well-being at the end of life.

Although identical twin-to-twin skin grafting has resulted in excellent survival rates in burn patients, the nature and scope of ethical decision making in monozygotic sibling skin grafting needs further examination.

When acting as a surrogate for incapacitated incarcerated patients, physicians may disclose protected health information to a patient’s legal counsel.