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Ernesto d’Aloja, MD, PhD; Michela Pintor, MD; Francesco Paribello, MD, PhD; Salvatore Pisu, MD

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Varma and Wendler¹ recently focused on the medical ethical challenge represented by the treatment for people lacking advanced directives or designated surrogates. They argue that it is fundamental to give them the same level of respect afforded those with surrogates. The clear identification of instruments to help physicians make treatment decisions consistent with the patient's preferences is mandatory. They propose a "population-based treatment indicator," a computer-based tool that should be able to unravel a patient's choice by relying on the treatment preference of comparable individuals. The data to be implemented into the decisional algorithm are mainly based on "age and sex, and features of the patient's clinical situation, such as diagnosis."^1(p1712)

We all know that the patient-physician relationship underwent an in-depth transformation over the last 50 years. The main achievement was the awareness that physicians cannot . . . [Full Text of this Article]

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Medical Decision Making for Patients Without Surrogates
Sumeeta Varma and David Wendler
Arch Intern Med. 2007;167(16):1711-1715.
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