HMC Ethics Forum | October 14

Deciding for Others: Ethical Ideals and Bedside Realities

This presentation examines the gap between the ethical standards guiding surrogate decision-making, and the emotional realities of making medical decisions for a loved one. Through clinical cases, it explores challenges that can arise for both surrogate decision-makers and clinicians, and highlights approaches to reconcile conflict and reach ethically supportable decisions.

OBJECTIVES:

1. Describe the ethical standards for surrogate decision-making—expressed wishes, substituted judgment, and best interests—and identify challenges to applying them in practice.

2. Analyze ethical tensions when surrogate requests differ from clinicians’ assessments of patients’ best interests or interpretations of advance directives.

3. Identify at least two communication strategies to elicit patients’ values and support surrogates through difficult decisions.

SPEAKER BIO:

Margot Hedlin, MD, MS, is a hospitalist at Harborview Medical Center, and an Assistant Professor of Clinical Practice at UW SOM. She is an executive producer and co-host of At the Bedside, a CoreIM podcast series exploring the ethical and emotional challenges of clinical care. Her narrative essays have appeared in The New England Journal of Medicine and JAMA.