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Ethics of Proxy Consent for Research Involving Patients With Adult Respiratory Distress Syndrome-Reply

Ronald B. Hirschl, MD; Robert H. Bartlett, MD; Rebecca Dresser, JD
JAMA. 1996;276(12):949-950. doi:10.1001/jama.1996.03540120027016.
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In Reply.  —Every day, practicing physicians are faced with obtaining "surrogate" consent for procedures and interventions from parents of minor children, foster parents, social service workers, those with power of attorney, family members, and legal guardians who make decisions on behalf of patients who are unable to do so for themselves. We rely on these advocates for the patient to represent the patient's interests in all aspects of their medical care, including the application of new operative and medical treatment. Is there a substantial difference between obtaining informed consent from the patient's representative for standard care or for an innovative treatment? We submit that there is not: in all cases, the tenets of informed consent, including the details of the procedure and the potential risks and benefits and alternatives, must be explained thoroughly in an understandable language to a patient advocate who can represent the interest of the currently incompetent patient. Our


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