Informed Consent and Surrogate Interference at the Initiation of Community-Based Palliative Care Services
Community-based palliative care (CBPC) clinicians sometimes contend with an ethically charged scenario when they encounter patients for the first time: The patient’s spouse, or other loved one or caregiver, revokes the patient’s valid informed consent to initiate care. While surrogates are usually m...
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2024-10-01
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| Series: | Palliative Medicine Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/pmr.2024.0018 |
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| author | John C. Stys |
| author_facet | John C. Stys |
| author_sort | John C. Stys |
| collection | DOAJ |
| description | Community-based palliative care (CBPC) clinicians sometimes contend with an ethically charged scenario when they encounter patients for the first time: The patient’s spouse, or other loved one or caregiver, revokes the patient’s valid informed consent to initiate care. While surrogates are usually motivated by protective instincts, there are other situations where surrogates act out of self-interest. This article considers whether it is ever ethically justified for an adult to revoke another adult’s valid informed consent to initiate palliative care services. The article examines this scenario from three perspectives: the patient’s capacity to give or relinquish informed consent, the surrogate’s intent and use of substituted judgment or best interest, and the clinician’s duty to provide clinical care. This ethical analysis argues that CBPC clinicians have an ethical responsibility to provide palliative care services for patients who have given valid informed consent for those services even when a surrogate acts as an interfering or oppositional force. |
| format | Article |
| id | doaj-art-3625d0fa1c094aeb8a4b43fcdeaf00f5 |
| institution | DOAJ |
| issn | 2689-2820 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Palliative Medicine Reports |
| spelling | doaj-art-3625d0fa1c094aeb8a4b43fcdeaf00f52025-08-20T02:59:07ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-10-015123423710.1089/pmr.2024.0018Informed Consent and Surrogate Interference at the Initiation of Community-Based Palliative Care ServicesJohn C. Stys0Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, Illinois, USA.Community-based palliative care (CBPC) clinicians sometimes contend with an ethically charged scenario when they encounter patients for the first time: The patient’s spouse, or other loved one or caregiver, revokes the patient’s valid informed consent to initiate care. While surrogates are usually motivated by protective instincts, there are other situations where surrogates act out of self-interest. This article considers whether it is ever ethically justified for an adult to revoke another adult’s valid informed consent to initiate palliative care services. The article examines this scenario from three perspectives: the patient’s capacity to give or relinquish informed consent, the surrogate’s intent and use of substituted judgment or best interest, and the clinician’s duty to provide clinical care. This ethical analysis argues that CBPC clinicians have an ethical responsibility to provide palliative care services for patients who have given valid informed consent for those services even when a surrogate acts as an interfering or oppositional force.https://www.liebertpub.com/doi/10.1089/pmr.2024.0018autonomybest interestcapacityconsentduty of caresubstituted judgment |
| spellingShingle | John C. Stys Informed Consent and Surrogate Interference at the Initiation of Community-Based Palliative Care Services Palliative Medicine Reports autonomy best interest capacity consent duty of care substituted judgment |
| title | Informed Consent and Surrogate Interference at the Initiation of Community-Based Palliative Care Services |
| title_full | Informed Consent and Surrogate Interference at the Initiation of Community-Based Palliative Care Services |
| title_fullStr | Informed Consent and Surrogate Interference at the Initiation of Community-Based Palliative Care Services |
| title_full_unstemmed | Informed Consent and Surrogate Interference at the Initiation of Community-Based Palliative Care Services |
| title_short | Informed Consent and Surrogate Interference at the Initiation of Community-Based Palliative Care Services |
| title_sort | informed consent and surrogate interference at the initiation of community based palliative care services |
| topic | autonomy best interest capacity consent duty of care substituted judgment |
| url | https://www.liebertpub.com/doi/10.1089/pmr.2024.0018 |
| work_keys_str_mv | AT johncstys informedconsentandsurrogateinterferenceattheinitiationofcommunitybasedpalliativecareservices |