When ethical or pragmatic questions arise concerning surrogate decision-making, nurse administrators often are consulted, so they must be knowledgeable about current legislation as well as the surrogate decision-maker's role and ethical obligations. Case exemplars are presented in this article to facilitate the reader's awareness on how value conflicts and communication failures can complicate surrogate decision-making. Recommendations for clinical practice and research are presented.
Marcia Sue DeWolf Bosek, DNSc, RN, Associate Professor in the Department of Adult Health Nursing and The Program in Ethics, Department of Religion, Health and Human Values, Rush University, Chicago, Ill.
Teresa A. Savage, PhD, RN, Research Assistant Professor, College of Nursing, Maternal-Child Nursing, University of Illinois at Chicago and Adjunct Instructor, Department of Physical Medicine and Rehabilitation, Northwestern University Medical School, Chicago, Ill.
Lisa Anderson Shaw, DrPH, RN, CS, Medical Ethics Consultant, Ethics Consult Service, University of Illinois at Chicago Medical Center, Chicago, Ill., Adjunct Instructor, College of Medicine, College of Nursing, University of Illinois at Chicago.
Camille Renella, RN, Clinical Medical Ethicist, Chief Ethicist in Patient Services at The University of Chicago Hospitals, Associate Faculty, MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Ill.