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Patient Autonomy or Surrogate Decision Maker?

NU NursingExpert Expert · 📅 25 June 2026 · ⏱ 2 min read
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Patients’ rights in the United States include the right to informed consent, which means that patients must receive adequate information to make medical decisions. However, many questions can arise if a patient appears to lack the capacity to understand his or her medical condition or options.

As a healthcare administrator, it is your responsibility to educate medical staff about your facility’s policy on obtaining informed consent, reflecting state law, and how to determine whether a patient is competent. It is essential to balance the moral needs of protecting the rights of the patient with the legal and ethical obligations to breach this confidentiality in certain select situations or determine circumstances requiring a surrogate decision maker.

Medical staff should have no difficulty in following a patient’s wishes specific to health treatment when the patient is a competent adult who can articulate his or her wishes to the medical team. However, what if the medical team is unable to determine competency? How would the team assess mental competency to understand benefits and risks of the medical treatment? If the patient is not competent, how should the medical staff proceed?

To prepare for this Discussion:

· View the Prompt Video titled Incident in the ER: Scene 1, located in the Learning Resources.

· Reflect on the delivery of healthcare services demonstrated in the Prompt Video regarding determining competency. Reflect on the positive and negative aspects demonstrated and consider how healthcare administrators should consider these aspects when engaged in practice.

· Using the Kaltura Video function as instructed in the Kaltura User Guide, you will videotape yourself responding to the Challenge Video. To upload your media to this Discussion thread, refer to the Kaltura User GuideLinks to an external site. for information about how to upload media to the course.

Post your video response to the Challenge Video, to address the following:

· Who decides on behalf of the patient if it is determined that the patient lacks competency?

· How should a surrogate decision maker proceed on behalf of a patient? How can a healthcare administrator ensure that the patient’s autonomy is ensured and competency is established?

· How do the facility’s standards and regulations affect how competency is determined?

Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.

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