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Rozzini and Trabucchi raise the issue of whether the relationship-centered guidelines we propose for surrogate decision making are useful in clinical practice. Instead, they propose that physicians ought to have “the final responsibility” to make surrogate decisions after a careful consideration of the patient, the surrogate, and the physician's own moral beliefs. We agree with Rozzini and Trabucchi that sharing the burden of decision making is a duty of a caring physician but do not agree that increased physician authority is the solution.
Torke A, Alexander GC, Lantos J, Siegler M. Physicians and Decision Making in Dementia—Reply. Arch Intern Med. 2008;168(2):242. doi:10.1001/archinternmed.2007.53