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Posted on January 22, 2021 at 3:00 AM

The editorial board of Neurology Today reflected back on 2020 to highlight advances—however large or small—that moved neurology and the field forward in the clinic, at the bench, in the therapeutic pipeline, and in areas of policy and practice. 

Here is the expert “pick” on the neurology news that mattered in 2020 in the area of "ethics." 

The Pick: Pope TM, Bennett J, Carson SC, et al, for the American Thoracic Society and American Geriatrics Society. Making medical treatment decisions for unrepresented patients in the ICU. Am J Respir Crit Care Med 2020; 201(10): 1182-1192.

The Findings: It is unfortunately a common problem that those with progressive neurologic disease or acute injury may not have an available surrogate decision maker; they are often referred to as “unrepresented patients.” In this joint policy statement by the American Thoracic Society and the American Geriatrics Society, the authors provide guidance on how institutions can ethically attend to these patients through the use of established strategies and institutional ethics committees.

Why It's Important: While the paper does not focus specifically or only on those patients with neurologic disease, it offers extremely useful recommendations for the practicing neurologist encountering such unrepresented patients in the hospital. It also provides a stark reminder of the importance of discussing with patients their medical choices while they are still well enough to do so, and encouraging the use of advance directives.

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