skip to main content

Surrogate decision-making — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeSurrogate decision-makingUSMLE Step 3

A ventilated patient lacks capacity and has no advance directive. His spouse reports that he would not want prolonged life support with little chance of recovery; an adult sibling wants all treatment continued. What ethical standard should guide the surrogate decision?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Use substituted judgment based on the patient’s known values

The legally appropriate surrogate should use substituted judgment when the patient’s values are known. Family disagreement does not displace the patient’s stated preferences; ethics consultation can help resolve conflict.

Reference: American Medical Association, Code of Medical Ethics: Decisions for Adult Patients Who Lack Capacity: https://code-medical-ethics.ama-assn.org/ethics-opinions/decisions-adult-patients-who-lack-capacity