Guidance for Healthcare Ethics Committees Quotes

“American Bar Association's booklet, Making Medical Decisions for Someone Else: A How-To Guide.”
― D. Micah Hester, Guidance for Healthcare Ethics Committees (Cambridge Medicine

“Cognitive issues Unfortunately, surrogates frequently do not understand the clinical status of the patients whom they represent. Some studies have shown that less than half of surrogates, regardless of educational level, had adequate knowledge of what was going on and what would happen to the patient. Sometimes, the surrogate lacks capacity to make the relevant decisions. But even when the surrogate has capacity, there are three key iatrogenic causes of surrogate misunderstanding. First, providers often fail to explain clearly the patient's condition and prognosis with clear, jargon-free language. Second, providers may place undue pressure on the surrogate and fail to allow sufficient time to process information. Third, different specialists often supply the surrogate with uncoordinated, even conflicting, information.”
― D. Micah Hester, Guidance for Healthcare Ethics Committees (Cambridge Medicine

“Nevertheless, there is growing consensus that continued life-sustaining treatment is qualitatively futile in two situations: (1) when a patient is permanently unconscious and/or (2) permanently totally dependent on intensive medical care. Some Canadian authorities have referred the former as the “minimum goal” of life-sustaining treatment. When permanently unconscious, patients have no thoughts, sensation, purposeful action, social interaction, awareness of self, or awareness of their environment. Therefore, the minimum goal does not comment on the quality of the patient's experience; rather it states that the patient must simply experience his/her own existence.”
― D. Micah Hester, Guidance for Healthcare Ethics Committees (Cambridge Medicine