Which statement about surrogates is true?

Which statement about surrogates is true?

• A. A surrogate's authority is unlimited
• B. A surrogate decision-maker should reflect the patient’s best interests, but not necessarily known preferences
• C. Surrogates act to ensure care aligns with known preferences when the patient cannot express them
• D. Surrogates can override patient preferences at any time

Answer: (C)

When a patient cannot express their wishes, the surrogate decision-maker aims to honor the patient’s autonomy by following any known preferences or values the patient previously stated. If those preferences are known, decisions should reflect them through substituted judgment. If there are no known preferences, the surrogate should base decisions on the patient’s best interests, weighing benefits and burdens of treatments and the likely impact on quality of life. Surrogates do not have unlimited authority and cannot override the patient’s values at will; their role is bounded by ethical duties, legal standards, and the need to involve clinicians and family when interpretations of wishes are unclear or absent. This is why the statement that surrogates act to ensure care aligns with known preferences when the patient cannot express them is the best description: it captures the responsibility to implement what the patient would have wanted, when those wishes are known, and to seek the patient’s best interests when they are not.

When a patient cannot express their wishes, the surrogate decision-maker aims to honor the patient’s autonomy by following any known preferences or values the patient previously stated. If those preferences are known, decisions should reflect them through substituted judgment. If there are no known preferences, the surrogate should base decisions on the patient’s best interests, weighing benefits and burdens of treatments and the likely impact on quality of life. Surrogates do not have unlimited authority and cannot override the patient’s values at will; their role is bounded by ethical duties, legal standards, and the need to involve clinicians and family when interpretations of wishes are unclear or absent.

This is why the statement that surrogates act to ensure care aligns with known preferences when the patient cannot express them is the best description: it captures the responsibility to implement what the patient would have wanted, when those wishes are known, and to seek the patient’s best interests when they are not.