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Posted on June 11, 2020 at 7:59 AM

Researchers from the Regenstrief Institute and Indiana University report in JAMA Open that nearly half of the time medical treatments and orders received for incapacitated patients were not compatible with goals of care requested by their surrogate decision makers.

The most common disagreement involved a “full-code” medical order prepared for patients whose surrogates had indicated preference for less aggressive care options.

Discord between orders and surrogate directions is not always cause for alarm. Because surrogates are often poor representatives of patient wishes, I have argued that they should sometimes be ignored and overridden. But without evidence that the surrogate is deviating from her job, their interpretation of patient wishes or best interests should control the incapacitated patient’s care. 

Alexia Torke

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