Patients who lack capacity and lack surrogates: can they enroll

J Pain Symptom Manage · Oct 2014

Review Case Reports

Patients who lack capacity and lack surrogates: can they enroll in hospice?

Patients who lack capacity and lack surrogates are among the most vulnerable patients we care for in palliative care. In the case we present here, we have considered how to make end-of-life decisions for a patient who lacks both capacity and surrogates, who has a terminal illness, and who is not a candidate for disease-modifying treatments. We first define and characterize this population of patients through a review of the literature and then explore some decision-making quandaries that are encountered at the end of life. Finally, we make recommendations on how best to proceed with decision making for this vulnerable population.

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- Andem Effiong and Stephanie Harman.
- Union Graduate College-Icahn School of Medicine at Mount Sinai, Schenectady, New York, USA; Georgetown University, Washington, DC, USA. Electronic address: andem.effiong@gmail.com.
- J Pain Symptom Manage. 2014 Oct 1;48(4):745-50.e1.
AbstractPatients who lack capacity and lack surrogates are among the most vulnerable patients we care for in palliative care. In the case we present here, we have considered how to make end-of-life decisions for a patient who lacks both capacity and surrogates, who has a terminal illness, and who is not a candidate for disease-modifying treatments. We first define and characterize this population of patients through a review of the literature and then explore some decision-making quandaries that are encountered at the end of life. Finally, we make recommendations on how best to proceed with decision making for this vulnerable population.Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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Patients who lack capacity and lack surrogates: can they enroll in hospice?

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