When Patients Cannot Consent: Should Families Decide?

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

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.

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.