If patient preferences and surrogate decisions conflict, which approach is appropriate?

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Multiple Choice

If patient preferences and surrogate decisions conflict, which approach is appropriate?

When patient wishes and a surrogate’s decisions clash, the best approach is to revisit prognosis and goals of care, then open a dialogue among the care team, the surrogate, and, if possible, the patient, to align decisions with the patient’s values. Provide clear information about likely outcomes and the options available, so decisions reflect what the patient would want—focusing on comfort, quality of life, and previously stated preferences. If needed, involve ethics resources or a palliative care team to help mediate and clarify values. This keeps care patient-centered and respects autonomy while addressing real-world disagreements.

When patient wishes and a surrogate’s decisions clash, the best approach is to revisit prognosis and goals of care, then open a dialogue among the care team, the surrogate, and, if possible, the patient, to align decisions with the patient’s values. Provide clear information about likely outcomes and the options available, so decisions reflect what the patient would want—focusing on comfort, quality of life, and previously stated preferences. If needed, involve ethics resources or a palliative care team to help mediate and clarify values. This keeps care patient-centered and respects autonomy while addressing real-world disagreements.

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