Ethics
This principle requires healthcare providers to act in the patient's best interest, avoiding preventable harm like pneumonia or musculoskeletal deconditioning.
beneficence
This process allows individuals to retain more control over their decisions by appointing someone to make decisions on their behalf, but it is often less restrictive than full guardianship.
Supported decision-making (SDM)
In Maryland, when a patient lacks decision-making capacity and has no advance directive, this individual is typically appointed to make healthcare decisions based on the patient’s known wishes or best interests.
Surrogate decision-maker
This Maryland law sets a hierarchy for assigning guardianship but may only help patients with someone legally or personally eligible to act on their behalf.
Maryland Estates and Trusts Code § 13-707
This Maryland law encourages the formation of ethics committees in healthcare facilities to advise on complex decisions, particularly in end-of-life care, though it does not grant these committees decision-making authority.
Maryland Patient Care Advisory Committee Act
What is the "high cost of the guardianship process"?
Maryland can cost over $10,000 per patient when trying to appoint someone to make medical decisions.
This ethical obligation requires healthcare providers to avoid preventable harm, which includes risks like pneumonia, barotrauma, and increased mortality due to delays in ventilator weaning.
Non-maleficence
This Maryland law provides a hierarchical process for assigning surrogate decision-makers when a patient has not left an advance directive, aiming to guide care based on the patient’s values and best interests.
Health Care Decisions Act (HCDA)
The current method of appointing a legal guardian in Maryland can cost over $10,000 per patient, while this proposed method involving health committees could offer a more cost-effective solution with lower operational costs.
Proposed health committee model