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ETH-015: Surrogate Decision Making

Surrogate Decision Making: The Wisconsin Medical Society supports legislation implementing the following concepts for health care decision making by family members in certain situations in an effort to keep this difficult decision within the health care setting and made by the family or close friends whenever possible, and to decrease the necessity for court intervention when a decision of continuing life-sustaining treatment is required for a patient.

  1. A surrogate decision maker shall make health care decisions including whether to forgo life-sustaining treatment on behalf of an incapacitated patient in consultation with the attending physician. The patient must have incapacity, defined as the inability to receive and evaluate information effectively or to communicate decisions to such an extent that the patient lacks the capacity to manage his or her health care decisions.
  2. Where possible, wishes expressed in a power of attorney for health care, or other advance directive should be honored if a patient is incapacitated. When no health care agent or guardian is authorized and available, the health care provider must make reasonable inquiry as to the availability of possible surrogate decisionmakers. The surrogate decision-maker is then authorized to make health care decisions, including whether to forgo life-sustaining treatment, on behalf of the patient without court order or judicial involvement.
    The following is the priority list of the individuals who can act as the surrogate decision maker:

    1. The patient’s spouse, domestic partner or life partner
    2. Any adult son or daughter of the patient
    3. Either parent of the patient
    4. Any adult brother or sister of the patient
    5. Any grandparent
    6. Any adult grandchild of the patient
    7. A close friend of the patient.
  3. A surrogate decision-maker shall make decisions for the patient conforming as closely as possible to what the patient would have done or intended under the circumstances, taking into account the patient’s personal philosophical, religious and moral beliefs, ethical values, sickness, medical procedures, and suffering. The patient’s best interests, weighing the burdens and benefits of initiating or continuing lifesustaining treatment, should be considered. If a health care provider believes that the decision made by the surrogate is not in the patient’s best interest, the provider may ask for a review by an ethics committee.
  4. If the ethics committee agrees with the surrogate, the health care provider shall follow through on the health care decision or transfer the care of the patient to another health care provider. If the ethics committee agrees with the provider, the surrogate can seek judicial review or file for guardianship under the law, but must do so within two weeks or the provider may follow the recommendations of the ethics committee.

The intentions of this Act are not to impair any existing rights or responsibilities that a health care provider, patient, or patient’s family have in regard to withholding or withdrawing life-sustaining treatment. (HOD, 0414)