More Problems with Surrogates at the End of Life

Much of the overly-aggressive medicine and many of the conflicts at the end-of-life are due to the fact that a surrogate, rather than the patient herself, makes the treatment decision.  A plethora of evidence already supports this point.  Now, in the July 2011 Journal of the American Geriatrics Society Alexia Torke and colleagues have published "Timing of Do-Not-Resuscitate Orders for Hospitalized Older Adults Who Require a Surrogate Decision-Maker."  

They conclude: "For patients who have a DNR order entered during their hospital stay, order entry occurs later when a surrogate is involved. Surrogate decision-making may take longer because of the greater ethical, emotional, or communication complexity of making decisions with surrogates than with patients."