title: Recommendations to Surrogates at the End of Life: A Critical Narrative Review of the Empirical Literature and a Normative Analysis.
abstract: Physician recommendations have historically been a part of shared decision making. Recent literature has challenged the idea that physician recommendations should be part of shared decision making at the end of life, particularly the making of recommendations to surrogates of incapacitated patients. Close examination of the studies and the available data on surrogate preferences for decisional authority at the end of life, however, provide an empirical foundation for a style of shared decision making that includes a physician recommendation. Moreover, there are independent ethical reasons for arguing that physician recommendations enhance rather than detract from shared decision making.
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois, USA.
authors.forename: Micah T
authors.initials: MT
authors.lastname: Prochaska
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois, USA; MacLean Center for Clinical and Medical Ethics, The University of Chicago, Chicago, Illinois, USA; The Divinity School, The University of Chicago, Chicago, Illinois, USA. Electronic address: dsulmasy@uchicago.edu.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Sulmasy
mesh_terms: D017028:Caregivers; D003142:Communication; D003657:Decision Making; D005190:Family; D006801:Humans; D010817:Physician-Patient Relations / Q000941:ethics; D011368:Professional-Family Relations / Q000941:ethics; D013727:Terminal Care / Q000941:ethics / Q000379:methods*
keywords: End-of-life care; communication; ethics; patient-physician relationship; recommendation; shared decision making; surrogates