When a Surrogate Knows What to Do, but Can’t Do It

Authors

  • Victor Esteban Grado Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA https://orcid.org/0009-0008-9690-5125
  • Maureen Pontarelli Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA https://orcid.org/0009-0002-3980-6653
  • Ian Doherty Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA https://orcid.org/0009-0004-9353-8789
  • Nico Nortjé Center for Clinical Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA https://orcid.org/0000-0002-3660-2762

DOI:

https://doi.org/10.7202/1126628ar

Keywords:

surrogate decision-maker, medical decision-making;, clinical ethics

Language(s):

English

Abstract

A surrogate or substitute decision-maker is tasked with making medical choices that the patient would make for themselves. However, most of the time the surrogate decision-maker is also emotionally involved with the patient, which makes the execution of these choices very difficult. This case study looks at a wife’s struggle to honour her husband’s wishes, because she did not want to lose him.

References

1. Jonsen AR, Siegler M, Winslade WJ. Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, ninth edition. New York: McGraw Hill; 2022.

2. Suhl J, Simons P, Reedy T, Garrick T. Myth of substituted judgment. Surrogate decision making regarding life support is unreliable. Arch Intern Med. 1994;154(1):90-6.

3. US Center for Substance Abuse Treatment. Chapter 3: Understanding the impact of trauma. In: Trauma-Informed Care in Behavioral Health Services. Rockville, Maryland: Substance Abuse and Mental Health Services Administration; 2014.

4. Su Y, Yuki M, Hirayama K. The experiences and perspectives of family surrogate decision-makers: A systematic review of qualitative studies. Patient Educ Couns. 2020;103(6):1070-81.

5. Bakke BM, Feuz MA, McMahan RD, et al. Surrogate decision makers need better preparation for their role: Advice from experienced surrogates. J Palliat Med. 2022;25(6):857-63.

6. Rogers AH, Lopez RP. Systematic review revisited, 2010-2020: The effect on surrogates of making treatment decisions for others. J Palliat Care. 2023;38(1):71-7.

7. Wendler D, Rid A. Systematic review: the effect on surrogates of making treatment decisions for others. Ann Intern Med. 2011;154(5):336-46.

© Han Han Li

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Published

2026-06-22

How to Cite

[1]
Grado VE, Pontarelli M, Doherty I, Nortjé N. When a Surrogate Knows What to Do, but Can’t Do It. Can. J. Bioeth 2026;9:125-7. https://doi.org/10.7202/1126628ar.

Issue

Vol. 9 No. 3 (2026): Open Issue

Section

Case studies

License

Copyright (c) 2026 Victor Esteban Grado, Maureen Pontarelli, Ian Doherty, Nico Nortjé

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The Canadian Journal of Bioethics applies the Creative Commons Attribution 4.0 International License to all its publications. Authors therefore retain copyright of their publication, e.g., they can reuse their publication, link to it on their home page or institutional website, deposit a PDF in a public repository. However, the authors allow anyone to download, reuse, reprint, distribute, and/or copy their publication, so long as the original authors and source are cited.