Associate Director Lauren Flicker Published a Paper with Colleagues in the American Journal of Hospice and Palliative Care Surrogate decision makers are called upon to inform medical teams what unconscious and decisionally incapacitated patients would have wanted for themselves. This task poses significant challenges for surrogates as they struggle to determine what the patient they represent would have wanted, which often takes a physical and emotional toll on the surrogate. Surrogates commonly voice hesitancy regarding withholding or withdrawing treatments, leading to the provision of potentially non-beneficial treatments, driving up costs both to the system and to the family, prolonging the dying process, and increasing distress for the family and the medical team. These ethical issues have been highlighted and exacerbated by the contemporary COVID-19 pandemic. Here we explore the unique manifestations of ethical issues surrounding surrogate decision-making in the COVID-19 context, particularly focusing on how triage, communication, time course and isolation impact the ethics of surrogate decisionmaking. (Mishkin AD, Allen NC, Cheung SG, Faccini MC, Flicker LS, Shalev D. The Stresses of Surrogate Decision-Making: Contributing Factors and Clinicians' Role in Mitigation. Am J Hosp Palliat Care. 2023 Sep 13:10499091231198750. doi: 10.1177/10499091231198750. Epub ahead of print. PMID: 37704184).
