Top Ten Tips Palliative Care Clinicians Should Know About Caring for Patients Under Guardianships

J Palliat Med. 2024 Sep 18. doi: 10.1089/jpm.2024.0318. Online ahead of print.

Abstract

Palliative care clinicians often help facilitate coordination of care, complex serious illness, and end-of-life medical decision-making. However, the clinical and legal issues related to guardianship can complicate the decision-making process, care delivery, outcomes, and the role of the palliative care clinician. Adult patients who have a guardian have been found by a court to be unable to make some or all decisions for themselves. Providing care for patients under guardianship is where medicine overlaps with legal rights. It is crucial to be familiar with the patients' rights and the guardians' responsibilities to clarify medical decision-making processes and identify necessary authorities. This article uses an interprofessional approach to leverage the expertise of physicians, nurses, lawyers, and guardians and to guide palliative care clinicians to optimally support patients under guardianship.

Keywords: end-of-life; guardianship; health care agent; medical decision-making; palliative care; scope of authority; serious illness.