title: New approaches with surrogate decision makers.
abstract: A first principle in ethics consultation is that reasoning is essential. A second principle is that the religious and cultural views of patients and their surrogates are usually respected. What can be done when these principles collide-when patients or surrogates have religious or cultural views and beliefs that clinicians find unreasonable or even offensive? Mediation may provide some approaches to assist us in providing the most ethically appropriate assistance.
authors.affiliation: Programs in Medical Ethics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814 USA. edmund.howe@uhuhs.edu.
authors.forename: Edmund G
authors.initials: EG
authors.lastname: Howe
mesh_terms: D016265:Conflict of Interest; D003466:Cultural Characteristics; D003657:Decision Making / Q000941:ethics*; D034723:Double Effect Principle; D004644:Emotions; D026822:Ethicists / Q000523:psychology / Q000592:standards; D033061:Ethics Consultation / Q000941:ethics / Q000592:standards; D006801:Humans; D018447:Medical Futility / Q000941:ethics / Q000523:psychology; D009014:Morals; D017008:Negotiating / Q000379:methods / Q000523:psychology; D059408:Pain Management / Q000941:ethics; D028723:Personhood; D011340:Problem Solving / Q000941:ethics*; D024382:Professional Role; D019727:Proxy; D011788:Quality of Life; D012068:Religion and Medicine; D006435:Renal Dialysis / Q000941:ethics; D012121:Respiration, Artificial / Q000941:ethics; D012945:Social Values; D013315:Stress, Psychological / Q000517:prevention & control; D013514:Surgical Procedures, Operative / Q000941:ethics; D014481:United States