title: Ethical considerations in stroke patients.
abstract: OBJECTIVE
  Medical decision-making in stroke patients can be complex and often involves ethical challenges, from the perspective of healthcare providers as well as patients and their families. Awareness of these challenges and knowledge of current ethical topics in stroke may improve the quality of care provided to stroke patients.
  
  
  RESULTS
  Predictive scores are increasingly available to estimate prognosis following stroke, though their usefulness in decision-making for individual patients remains unclear. Medical decisions requiring a surrogate decision-maker can be challenging; surrogates may also be susceptible to systematic biases in their decision-making. Variations in care are common and possibly related to under-utilization or over-utilization of resources. However, patient preferences may explain some of the variability as well. Early mortality may be related to patient and family preferences regarding life-sustaining measures rather than the provision of care that is not well tolerated or evidence-based.
  
  
  CONCLUSIONS
  Ethical challenges are common in the care of stroke patients. An effective understanding of these topics is essential for clinicians to deliver patient-centered, preference-sensitive care.
authors.affiliation: Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Adam G
authors.initials: AG
authors.lastname: Kelly
authors.forename: Bogachan
authors.initials: B
authors.lastname: Sahin
authors.forename: Robert G
authors.initials: RG
authors.lastname: Holloway
mesh_terms: D003657:Decision Making / Q000941:ethics*; D003695:Delivery of Health Care / Q000941:ethics*; D006801:Humans; D020521:Stroke / Q000523:psychology* / Q000628:therapy*