Bioethics Blogs

South Carolina Addressing Decision Making for Unbefriended

This session, several states are addressing gaps in how medical treatment decisions are made for patients without surrogates (the “unbefriended”).  South Carolina is proposing to add two additional categories of decision makers at the end of its default surrogate list (for a total of 11 categories) .


(1) A close friend of the patient who is an adult and reasonably is believed by the health care professional to have a close personal relationship with the patient;

(2) A clinical social worker . . . or an individual who is a graduate of a court-approved guardianship program.

Apparently following the long-standing rule in Florida, the bill requires that a person serving as a decision maker pursuant to the final criteria must be “selected by the provider’s bioethics committee and must not be employed by the provider.”

“If the provider does not have a bioethics committee, the provider’s governing body shall designate a committee of the governing body comprised of at least three members to select the person who shall serve as the decision maker . . . . The person serving as the decision maker must be notified that, upon request, the provider shall make available a second physician, not involved in the patient’s care, to assist the person in evaluating treatment options. A decision to withhold or withdraw life-prolonging procedures must be reviewed by the provider’s bioethics committee or the committee designated by the provider’s governing body pursuant to this subsection. Documentation of efforts to locate a decision maker [in a higher default category] must be recorded in the patient’s medical record.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.