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Surrogate decision-making — USMLE Step 3 MCQ

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

A 68-year-old man with advanced dementia is hospitalized with aspiration pneumonia and lacks decision-making capacity. He has no written directive. His daughter is legal surrogate and says he previously valued comfort and avoiding burdensome treatment. Which of the following is the most appropriate at this time?

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

Reveal the answer and explanation

Correct answer: E — Use substituted judgment based on the patient's known values

Surrogates should apply substituted judgment when the patient's values and preferences are known.

Reference: AMA Code of Medical Ethics and patient safety principles: https://code-medical-ethics.ama-assn.org/