In certain situations, Do Not Resuscitate Orders (DNR) can be issued by surrogate healthcare decisionmakers for minors or adult patients who are incompetent or otherwise mentally or physically incapable of communicating. While the specific requirements may vary by state, generally, appropriate legal guardians and/or medical care providers have the authority to decide whether to withhold or withdraw life-sustaining treatment.
Who Is an Authorized Surrogate?Depending on the individual patient and the particular circumstances, states recognize the following as authorized surrogates:- Legal Guardians
- Spouses
- Adult Children
- Parents
- Adult Siblings
- Adult Grandchildren
- Close Friends
- Guardian of Patient's Estate
In the absence of any of the above surrogates, healthcare providers can, in certain situations, also act as surrogate decisionmakers. Who Decides When There Are Multiple Authorized Surrogates?If there are multiple surrogate parties, conflicts can arise as to whose authority takes precedence. If the parties do not agree on the appropriate course of action, then they may resort to the court to make the determination. Establishing a do not resuscitate order in advance or identifying and empowering a single surrogate party in cases of minors or incapacitated adults can help prevent such conflicts. Determining Appropriateness of Issuing a DNR Order by Surrogate
If the court system is used to determine the appropriateness of issuing a DNR Order by Surrogate, two main standards will likely be applied: - Substituted Judgment Standard
- Best Interests Standard
The Substituted Judgment Standard is primarily used in cases of adults who have been incapacitated and cannot communicate their wishes. In applying this standard, the decisiomaker must determine as much as possible the decision the patient would have likely made. The Best Interests Standard is more often used in cases of infants and minors whose judgment would not likely be used but instead whose best interest must be determined by the surrogate decisionmaker.
Should I Contact a Lawyer Concerning Surrogate DNR Decisions?
It will be vital if you have concerns about surrogate DNR decisions that you get a good attorney to help persuade the court what the right arrangement is for the patient. |
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