Medicine and the Law: What doctors should know when working with surrogate decision-makers who disagree with their treatment plans

• Published in: South African medical journal 2023-09, Vol.113 (9), p.20-21
• Main Author: McQuoid-Mason, D J
• Format: Article
• Language: English
• ISSN: 0256-9574; 2078-5135
• DOI: 10.7196/SAMJ.2023.v113i9.707

Problems arise when a lawfully appointed surrogate decision-maker wishes to decide on a course of action on behalf of a mentally incompetent patient that is against the patient’s best interests. This may arise: (i) where there is no advance directive, and the decision is made by the surrogate decision-maker on religious grounds; (ii) where the medical practitioners are of the opinion that the surrogate decision-maker’s decision is not in the best interests of the patient; (iii) where the close relatives of the patient do not agree with the decision by the surrogate decision-maker; and (iv) where the surrogate decision-maker asks the medical practitioners to undertake treatment or a procedure on the patient that is unlawful or unethical. Suggestions are made regarding what doctors should do when faced with each of these situations.