I feel pretty comfortable that we made the right decision for her, but it's still something that I think I don't think I realized how hard that decision would be to make.

We wanted to start off with the voices of people whose experience doesn't always reach the spotlight, surrogate decision makers.

Surgeons are people who make decisions for patients who can't make those decisions for themselves,

and they face a unique set of challenges that we don't generally

learn about in our training. Today we're going to learn about those challenges and find ways

that clinicians can support surrogates through the decision-making process.

Welcome back to At the Bedside, I'm Margot. I'm Joffer. And I'm Tamar. Let me introduce our expert, Dr Lisa

Vigg, who spoke with us about our research on circuit decision-makers.

I am a geriatrician and a palliative care specialist.

I am based at the Seattle VA hospital,

and I am also on the faculty at the University of

Washington. So I am the chair of the ethics committee here at the VA.

We'll also be speaking with four people who have been surrogate

decision makers who will introduce and fall a bit later. We wanted to start with a

very brief bit of background on how surrogate decision makers or health care proxies get appointed and how they make decisions.

So they're usually chosen by patients either in an advanced directive or by just telling a clinician,

which often happens when a patient is admitted to the hospital.

If a patient doesn't have capacity and doesn't have a surrogate, there are legal hierarchies that we can

follow to designate one.

For example, in New York, it's a legal guardian, followed by a spouse or domestic partner, then an adult child and so on.

But how are circuits supposed to make decisions for the patient?

What are they supposed to take into consideration?

...