Clinical Practice Issues Practice Exam

A surrogate decision-maker steps in when the patient lacks capacity to make medical choices. Their role is to represent what the patient would want, using substituted judgment when possible; if the patient’s wishes are unknown, they should decide in the patient’s best interests, guided by any advance directives or previously stated values. When conflicts arise—such as disagreements among family or between family and clinicians—the appropriate path is to bring in ethics consultation and use a structured process (like a family conference) to clarify the patient’s values and the clinical options, ensuring decisions align with the patient’s wishes and best interests. Surrogates should not override known wishes without proper review, and their responsibilities cover medical decisions, not just financial matters.