At a threshold: making decisions when you don't have all the answers

• Published in: Physical medicine and rehabilitation clinics of North America Vol. 18; no. 1; p. 1
• Main Authors: Burck, J Russell, Vena, Marvel, Jolicoeur, Mark, Jolicoeur, Laurie Edge
• Format: Journal Article
• Language: English
• Published: United States 01.02.2007
• Subjects: Brain Injuries - therapy; Communication; Decision Making; Family; Female; Guidelines as Topic; Humans; Informed Consent - ethics; Male; Patient Advocacy - ethics; Patient Advocacy - psychology
• ISSN: 1047-9651
• DOI: 10.1016/j.pmr.2006.10.001

Many people who sustain a brain injury also lose decisional capacity. They need someone who will be a partner with clinicians in making decisions on their behalf. This article reviews ethical aspects of decision making; the legal foundation in the United States for surrogate decision making; the experience of surrogate decision making on behalf of people who have a brain injury, including similarities and differences between such decision making for the dying and for those who have a brain injury; and ways to approach intractable disagreements between surrogate or family and clinicians. It provides guidelines for clinicians and surrogates and suggests topics for research. Two people who have suffered a brain injury and the spouse of one are coauthors.