Which statement about surrogate decision-making best aligns with patient autonomy?

Which statement about surrogate decision-making best aligns with patient autonomy?

• A. Surrogates should override patient preferences if the family wants
• B. Surrogates have authority only in the absence of any known patient preferences
• C. Surrogates act to reflect the patient’s best interests when the patient cannot decide
• D. Surrogates should reflect the patient’s known preferences and best interests when the patient cannot decide

Answer: (D)

Respecting patient autonomy means honoring what the patient would have chosen based on their own values and preferences, and when they can’t decide, the surrogate should act in line with those known wishes. If the patient’s preferences aren’t known, the surrogate should base decisions on the patient’s best interests. The statement that surrogates reflect the patient’s known preferences and best interests captures both steps: first try to honor what the patient would want, and when that isn’t known, make judgments that promote the patient’s welfare. Overriding the family’s wants ignores the patient’s autonomy. Limiting surrogate authority to only when no preferences exist fails to prioritize known patient preferences. Focusing solely on the patient’s best interests without considering any known wishes can undermine autonomy by substituting the surrogate’s values for the patient’s.

Respecting patient autonomy means honoring what the patient would have chosen based on their own values and preferences, and when they can’t decide, the surrogate should act in line with those known wishes. If the patient’s preferences aren’t known, the surrogate should base decisions on the patient’s best interests. The statement that surrogates reflect the patient’s known preferences and best interests captures both steps: first try to honor what the patient would want, and when that isn’t known, make judgments that promote the patient’s welfare.

Overriding the family’s wants ignores the patient’s autonomy. Limiting surrogate authority to only when no preferences exist fails to prioritize known patient preferences. Focusing solely on the patient’s best interests without considering any known wishes can undermine autonomy by substituting the surrogate’s values for the patient’s.