State Plans for Surrogate Decision Making-Reply

Abstract

In Reply. —In our federal system, states remain the laboratories for innovation. Dr Eckoff's account of Iowa's program for patients with disabilities, enacted 4 years after the New York law we described, affirms our conclusions: the New York approach is readily transferable to other states and it can and should be available to persons in mental disability facilities, to incapacitated nursing home residents, and to others in need of surrogate decision makers. Our concern is with Eckoff's view that a guardian need eventually be appointed if the patient requires substituted decision making over a period of time. The New York law has several features that allow a more flexible response to this type of situation. First, the New York State Surrogate Decision-Making Committee panels can be convened quickly (usually within 14 days), 1 and they are required to make their decisions on the day of the hearing where practicable. 2