At a threshold: making decisions when you don't have all the answers

Phys Med Rehabil Clin N Am. 2007 Feb;18(1):1-25, v. doi: 10.1016/j.pmr.2006.10.001.


Many people who sustain a brain injury also lose decisional capacity. They need someone who will be a partner with clinicians in making decisions on their behalf. This article reviews ethical aspects of decision making; the legal foundation in the United States for surrogate decision making; the experience of surrogate decision making on behalf of people who have a brain injury, including similarities and differences between such decision making for the dying and for those who have a brain injury; and ways to approach intractable disagreements between surrogate or family and clinicians. It provides guidelines for clinicians and surrogates and suggests topics for research. Two people who have suffered a brain injury and the spouse of one are coauthors.

Publication types

  • Review

MeSH terms

  • Brain Injuries / therapy*
  • Communication
  • Decision Making*
  • Family
  • Female
  • Guidelines as Topic
  • Humans
  • Informed Consent / ethics
  • Male
  • Patient Advocacy / ethics
  • Patient Advocacy / psychology*