Match each clinical scenario or description with the appropriate legal or ethical concept regarding surrogate decision-making.
- A surrogate refuses a feeding tube for an incapacitated patient, stating, 'He told me many times he would never want to live like this.'Substituted judgment standard
- A guardian makes medical decisions for an adult patient who has had profound, lifelong cognitive impairment and has never been able to express healthcare preferences.Best interest standard
- An incapacitated patient arrives at the emergency department with life-threatening bleeding. No family members or identification are present.Emergency consent exception
- A competent patient legally designates their sister to make healthcare decisions for them in the event they lose medical decision-making capacity.Healthcare proxy
Answer
1) Surrogate using known values matches with Substituted judgment standard. 2) Guardian for lifelong impaired patient matches with Best interest standard. 3) Life-threatening bleeding with no family matches with Emergency consent exception. 4) Legal designation of a decision-maker matches with Healthcare proxy.
Each standard applies to a distinct clinical and legal scenario. Substituted judgment applies when the patient's values are known to the surrogate. The best interest standard applies when values are unknown or capacity was never present. The emergency consent exception applies when immediate life-saving care is required and surrogates are unavailable. A healthcare proxy is the legal role of the individual who enacts these standards on the patient's behalf.
Step-by-Step Solution
Key Concept
Advance Directives and Surrogate Decision Making