When mediation fails: identifying and working with inappropriate surrogate decision makers

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• For example, Texas allows clinicians to not provide futile LST despite SDM demands for such (see Pope, TM. Surrogate Selection, at Note 25). Similarly, Iowa allows competent and incompetent adults by means of a SDM to withhold or withdrawn life-sustaining treatment, but the definition of life-sustaining treatment explicitly excludes ‘the administration of medication or performance of any medical procedure deemed necessary to provide comfort care or to alleviate pain (Life-sustaining Procedures Act, Iowa Code Annotated Sec. 144A.2(8)).
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