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The Limits of Surrogates’ Moral Authority and Physician Professionalism: Can the Paradigm of Palliative Sedation Be Instructive?
Author(s) -
Berger Jeffrey T.
Publication year - 2017
Publication title -
hastings center report
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.515
H-Index - 63
eISSN - 1552-146X
pISSN - 0093-0334
DOI - 10.1002/hast.665
Subject(s) - palliative sedation , scope (computer science) , palliative care , bioethics , sedation , health authority , informed consent , psychology , medicine , law and economics , law , engineering ethics , political science , nursing , sociology , alternative medicine , computer science , surgery , pathology , programming language , engineering
With narrow exception, physicians’ treatment of incapacitated patients requires the consent of health surrogates. Although the decision‐making authority of surrogates is appropriately broad, their moral authority is not without limits. Discerning these bounds is particularly germane to ethically complex treatments and has important implications for the welfare of patients, for the professional integrity of clinicians, and, in fact, for the welfare of surrogates. Palliative sedation is one such complex treatment; as such, it provides a valuable model for analyzing the scope of surrogates’ moral authority. Guidelines for palliative sedation that present it as a “last‐resort” treatment for severe and intractable suffering yet require surrogate consent in order to offer it are ethically untenable, precisely because the moral limits of surrogate authority have not been considered.