When Patients Cannot Consent: Should Families Decide?

Credit Available

* You will be redirected to the BCM DCPD credit management site when claiming credit and may be asked to register or log in.

In this presentation, Dr. Maggie Taylor discusses the process of obtaining medical consent from familial surrogates of patients who once had decision-making capacity and did not previously communicate their preferences. She also reviews the ethical principles and legal authority that support this practice.
This Bioethics Grand Rounds session took place on Wednesday, April 12, 2023 at 1:00 p.m. and has been approved for CME, Ethics, and Social Work Credit.

Activity Information

How to Claim Credit

You may claim credit after watching this activity.

You will be redirected to the BCM DCPD credit management site when claiming credit and may be asked to register or log in.

Needs Statement

Ethical dilemmas can arise in the day-to-day practice of physicians, nurses, social workers, advanced practice providers, and other allied health professionals. The series aims to review classic and emerging issues in healthcare, focusing on developments in the field of clinical ethics, the practice of ethics consultation, and the role of ethics in shared clinical decision-making. The series also aims to expand the knowledge of learners, foster the skills needed to resolve ethical dilemmas in clinical practice, and enhance the quality of patient care.

Educational Objectives

At the conclusion of the session, the participants should be able to:

  • Describe the substituted judgment standard for surrogate decision-making.
  • Explain the rationale for relying on family members to make substituted judgments for their loved ones.
  • Identify what skills, knowledge, and traits are necessary to make substituted judgments.
  • Assess family members to determine which of them are capable of making substituted judgments.
  • Outline a model of shared decision-making for substituted judgments that incorporates familial knowledge alongside medical expertise and moral reasoning.

Target Audience

Professional Categories

  • Physicians
  • Medical Students
  • Fellows
  • Residents
  • Nurses
  • Other Health Professionals

Specialties

Interest Groups

  • Ethics
  • Hospital Medicine
  • Primary Care

Activity Evaluation

Evaluation by questionnaire will address program content, presentation, and possible bias.

Educational Methods

  • Lectures

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Baylor College of Medicine designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity has been designated by Baylor College of Medicine for 1.0 credit of education in medical ethics and/or professional responsibility.

Social Work: The Baylor College of Medicine Division of Continuing Professional Development (License Number 7270) is an approved continuing education provider for Social Workers through the Texas State Board of Social Worker Examiners. This activity has been approved for 1 continuing education unit.

Activity Director

  1. Janet Malek Weinstein, Ph.D.

    Janet Malek Weinstein, Ph.D.

    Associate Professor
    Baylor College of Medicine

Term of Approval

April 1, 2023 through April 30, 2025. Original release date: April 1, 2023.

Disclosure Policy

Baylor College of Medicine (BCM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians. BCM is committed to sponsoring CE activities that are scientifically based, accurate, current, and objectively presented.

In accordance with the ACCME Standards for Commercial Support, BCM has implemented a mechanism requiring everyone in a position to control the content of an educational activity (i.e., directors, planning committee members, faculty) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships at the time of the activity or within 24 months prior.

In addition, BCM has requested activity faculty/presenters to disclose to participants any unlabeled use or investigational use of pharmaceutical/device products; to use scientific or generic names (not trade names) in referring to products; and, if necessary to use a trade name, to use the names of similar products or those within a class. Faculty/presenters have also been requested to adhere to the ACCME's validation of clinical content statements.

BCM does not view the existence of financial relationships with commercial interests as implying bias or decreasing the value of a presentation. It is up to participants to determine whether the relationships influence the activity faculty with regard to exposition or conclusions. If at any time during this activity you feel that there has been commercial/promotional bias, notify the Activity Director or Activity Coordinator. Please answer the questions about balance and objectivity in the activity evaluation candidly.

All of the relevant financial relationships listed for these individuals have been mitigated.

Disclosures

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

Presenter

  1. Maggie Taylor, Ph.D.

    Maggie Taylor, Ph.D.

    Clinical Ethics Fellow
    Center for Medical Ethics and Health Policy, Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

Activity Director

  1. Janet Malek Weinstein, Ph.D.

    Janet Malek Weinstein, Ph.D.

    Associate Professor
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

Planning Committee Members

  1. Trevor Bibler, Ph.D.

    Trevor Bibler, Ph.D.

    Assistant Professor
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  2. Marisa B. Buchmann, M.S.N., R.N., C.P.N. Placeholder Image

    Marisa B. Buchmann, M.S.N., R.N., C.P.N.

    Nursing Professional Development Leader
    Houston Methodist Hospital

    Disclosure:

    Nothing to disclose.

  3. Leon Budrie, M.D., M.B.A., M.S.

    Leon Budrie, M.D., M.B.A., M.S.

    Clinical Ethics Fellow
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  4. Laura Ortiz Carter, M.S.N., B.B.A., R.N., C.C.R.N., RNC-OB, C-EFM Placeholder Image

    Laura Ortiz Carter, M.S.N., B.B.A., R.N., C.C.R.N., RNC-OB, C-EFM

    Registered Nurse
    Houston Methodist Hospital

    Disclosure:

    Nothing to disclose.

  5. Andrew Childress, Ph.D.

    Andrew Childress, Ph.D.

    Assistant Professor
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  6. David Garvis, Ph.D. Placeholder Image

    David Garvis, Ph.D.

    Clinical Ethicist
    Baylor St. Luke’s Medical Center

    Disclosure:

    Nothing to disclose.

  7. Clarise Jacobson

    Clarise Jacobson

    Senior Business Strategy and Development Associate
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  8. Holland Kaplan, M.D.

    Holland Kaplan, M.D.

    Clinical Ethics Fellow
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  9. Janet Malek Weinstein, Ph.D.

    Janet Malek Weinstein, Ph.D.

    Associate Professor
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  10. Susan M. Miller, M.D., M.P.H.

    Susan M. Miller, M.D., M.P.H.

    Professor and Chair, General Internal Medicine
    Houston Methodist Hospital

    Disclosure:

    Nothing to disclose.

  11. Adam Pena, LL.M., J.D., M.A.

    Adam Pena, LL.M., J.D., M.A.

    Assistant Professor
    Center for Medical Ethics and Health Policy, Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  12. Joelle Robertson-Preidler, Ph.D.

    Joelle Robertson-Preidler, Ph.D.

    Clinical Ethics Fellow
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  13. Sabrina Wallace Placeholder Image

    Sabrina Wallace

    Patient Care Coordinator
    Houston Methodist Hospital

    Disclosure:

    Nothing to disclose.

Presenter:

Maggie Taylor, Ph.D.

Maggie Taylor, Ph.D.

Clinical Ethics Fellow Center for Medical Ethics and Health Policy, Baylor College of Medicine

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