Noemi Nurses and Other Health Professionals' Engagement in P

Noemi Nurses and Other Health Professionals' Engagement in Proxy Reports and Pediatric Decision-Making Noemi nurses and other health professionals have increasingly engaged in proxy reports to promote a high quality of life for children and infants whose age prevents them from reliably self-reporting. They must acknowledge that a patient’s incompetence does not influence their obligation to deliver treatment that reflects a patient’s best interests. The proxy subjective health status for children or those unable to self-report has underlying assumptions and potential ramifications. Caregivers have increasingly applied proxy evaluation techniques to understand the impact of disease and treatment on children unable to self-report. Proxy decisions have triggered concerns regarding the caregivers’ commitment to patient autonomy. Nurses have a challenging obligation to ensure the patient’s best interests align with the treatment decisions when those patients require a representative to speak for them (Germain et al., 2019). An underlying assumption proposes the moral appropriateness of substituted judgment for a proxy decision-maker. Clinicians must acknowledge that proxy decision-making could be ineffective if individual interests influence the proxies’ judgment. For instance, a parent may demand the treatment they want their child to have rather than the treatment the child could have wanted. They may justify the treatment using false information to convince a caregiver to prescribe inappropriate and potentially harmful medical care to the patient. Caregivers should decline proxy requests that fail to reflect patients’ wishes. Physicians must never allow proxy interests to override considerations of what is best for the patients (Dorscheidt & Doek, 2018). The concept of substituted judgment compels clinicians to consider the importance of proxy decisions over the medical interests of patients where those clinical decisions significantly influence the entire family. Unfortunately, in many cases, pediatric decision-making has overlooked the morally best treatment because of limited medical resources. Lastly, many concerns have arisen regarding the reliability of proxy reports. Various recent recommendations have argued that proxy reports are relevant for observable concepts rather than concepts of interpretation such as social functioning. Conducting extensive research on the validity and reliability of proxy reports to children at different developmental stages is paramount. The approach will support the evaluation and promote new and existing measures for effective pediatric decision-making (Pickard & Knight, 2005).