Med Health Care Philos. 2014 Jun 14. [Epub ahead of print]

Biologically-related or emotionally-connected: who would be the better surrogate decision-maker?

Watson A1, Sheridan B, Rodriguez M, Seifi A.

Author information

• 1Department of Neurosurgery, University of Texas Health Science Center at San Antonio, Mail Code 7843, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.

Abstract

As an incapacitated patient is unable to make decisions regarding their care, physicians turn to next-of-kin when appointing a surrogate decision-maker in the absence of an advanced directive. With the increasing complexity of modern families, physicians are facing new ethical dilemmas when choosing the individual to make end-of-life decisions for their patients. Legal definitions and hierarchies are no longer adhering to the purpose of a surrogate-decision maker, which is to maintain a patient's autonomy. Moral criteria for surrogates, which emphasize the importance of making decisions that align with the patient's desires and wishes and negate biological relationships over emotional connections, are becoming much more important. This paper explores a case study in which physicians must appoint a surrogate decision-maker for an incapacitated patient, forced to choose between a biological relationship and a strong emotional connection.