Thaddeus Mason Pope

Bioethics, Health Law, Patient Rights

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Unrepresented / Unbefriended Patients
This page collects resources on how to make decisions for incapacitated patients with no available surrogate. These individuals are often referred to as unrepresented for unbefriended patients. I have divided the page into these six sections:
  1. Articles by Professor Pope
  2. Presentations by Professor Pope
  3. Statutes
  4. Cases
  5. Legal & Medical Literature
  6. Facility & Society Policies

Articles by Professor Pope
Making Medical Treatment Decisions for Unrepresented Patients in the ICU: An Official American Thoracic Society/American Geriatrics Society Policy Statement, 201(10) AMERICAN JOURNAL OF RESPIRATORY & CRITICAL CARE MEDICINE 1182-1192 (2020).

Five Things Clinicians Should Know When Caring for Unrepresented Patients,, 21(7) AMA JOURNAL OF ETHICS 581-585 (July 2019)..

Unbefriended and Unrepresented: Medical Decision Making for Incapacitated Patients without Healthcare Surrogates, 33(4) GEORGIA STATE UNIVERSITY LAW REVIEW 923-1019 (2017).

Legal Briefing: Adult Orphans and the Unbefriended: Making Medical Decisions for Unrepresented Patients without Surrogates, 26(2) JOURNAL OF CLINICAL ETHICS 180-188 (2015).

Making Medical Decisions for Patients without Surrogates, 369(21) NEW ENGLAND JOURNAL OF MEDICINE 1976-1978 (2013).

Legal Briefing: The Unbefriended: Making Healthcare Decisions for Patients without Proxies (Part 1), 23(1) J. CLINICAL ETHICS 84-96 (2012) (with Tanya Sellers).

Legal Briefing: The Unbefriended: Making Healthcare Decisions for Patients without Proxies (Part 2), 23(2) J. CLINICAL ETHICS 177-192 (2012) (with Tanya Sellers).

Legal Fundamentals of Surrogate Decision Making, 141(4) CHEST 1074-1081 (2012).

Presentations by Professor Pope
Care of Unrepresented Older Adults: Updating the AGS Ethics Committee Position Statement, AMERICAN GERIATRICS SOCIETY ANNUAL SCIENTIFIC MEETING, Chicago, Illinois (May 8-10, 2025) (with Rachel Brenner, Timothy Farrell, Yael Zweig, Joe Dixon).

Better Decision Making for Unrepresented Patients, LEGACY HEALTH, Portland, Oregon (November 12, 2024).

Making Treatment Decisions for Unrepresented Patients, VERMONT ETHICS NETWORK (November 9, 2020).

Making Better Healthcare Decisions for Unrepresented Patients in California, UCLA HEALTH, Los Angeles, California (January 17, 2018).

Better Decision Making for Unrepresented Patients, CITIZEN'S LEAGUE TASK FORCE - A BACKUP PLAN FOR SOLOS (WILDER CENTER), Saint Paul, Minnesota (December 12, 2017).

Better Decision Making for Unrepresented Patients, UNIVERSITY OF MINNESOTA CENTER FOR BIOETHICS, Minneapolis, Minnesota (December 5, 2017).

Unbefriended and Unrepresented: Medical Decision Making for Incapacitated Patients without Healthcare Surrogates, MINNESOTA ELDER JUSTICE CENTER, Saint Paul, Minnesota (December 9, 2016).

Caring for the “Unrepresented Patient”: Strategies to Avoid Moral Distress and Substandard Car, INTERNATIONAL CONFERENCE ON CLINICAL ETHICS CONSULTATION (ICCEC), Washington, DC (May 21, 2016).

The Unbefriended Must Not Be Unprotected: Organizational and Clinical Management of Patients Without Surrogates, ASBH 17th ANNUAL MEETING, Houston, Texas (October 22-25, 2015).

The Unbefriended Elderly: Making Medical Decisions for Patients without Surrogates, AMERICAN ASSOCIATION OF LAW SCHOOLS (AALS), Washington, DC (January 3, 2015) (organized and moderated program co-sponsored by Section on Law & Aging; and Section on Law, Medicine and Health Care).

Pope PPT Handout for AGS (May 2025)
Pope PPT Handout for Legacy (Nov. 12, 2024)
Pope PPT Handout for UCLA (Jan. 17, 2018)
Statutes
Montana S.B. 92 (2017) (medical proxy with HEC)
Colorado HB 1101 (May 2016) (medical proxy with HEC)
California Health & Safety Code 1418.8 (interdisciplinary team, Epple committee)
California 2015 statute for prisoners (medical supervisor)
ABA Commission - Chart on Surrogate Statutes (2014)
Court Cases
CANHR v Smith (Cal. App. July 2019) (Opinion)
CANHR v. Smith (Cal App) (PTF response to CAHF)
CANHR v. Smith (Cal App) (PTF response to CMA CHA CDA)
CANHR v. Smith (Cal App) (AARP amicus brief)
CANHR v. Smith (Cal App) (CA LTC Ombudsperson Assn amicus brief)
CANHR v. Smith (Cal App) (Disability Rights CA amicus brief)
CANHR v. Smith (Cal App Sept 29, 2017) (ACLU amicus brief)
CANHR v. Smith (Cal App Sept 29, 2017) (AARP amicus brief)
CANHR v Smith (Cal App June 13, 2017) (reply brief)
CANHR v. Smith (Cal App April 2017) (CMA CHA CDA amicus brief)
CANHR v. Smith (Cal App Jan 17, 2017) (Respondent Brief)
CANHR v. Smith (Cal App Nov 17, 2016) (Appellant Brief)
CANHR v Chapman (Alameda Sup Ct Jan 2016) (final judgment)
CANHR v. Chapman (Alameda Sup Ct, Cal. 2015) (Order granting petition)
CANHR v. Chapman (Alameda Sup. Ct., Cal. 2013) (Complaint)
In re Tschumy (Minn. 2014)
In re Tschumy (Minn. App. 2013)
In re Turner (Disability Rts Cal. 2013)
In re Yeager (Colo. App. 2004)
Rains v Belshe (Cal App 1995)
Legal & Medical Literature
CANHR, FAQ on CA LTC Consent (2017)
Harvard Community Ethics Committee, MEDICAL DECISION-MAKING FOR UNKNOWN and UNREPRESENTED PATIENTS
IOM (Institute of Medicine), Dying in America 146-47 (2015)
Karp & Wood, ABA, Incapacitated and Alone (2003)
Kilgore, CARING FOR THE AGES (2014)
New York State Task Force on Life and the Law (1992)
Ortiz, NORC, Informational Brief on Unbefriended-Elders (2010)
Pope, GEORGIA STATE UNIVERSITY LAW REVIEW (2017)
Pope, CHEST (2012)
Pope, NEW ENGLAND JOURNAL OF MEDICINE (2013)
Pope, JOURNAL OF CLINICAL ETHICS (2015) (1st page only)
Pope, J CLINICAL ETHICS (2012 - Part 1) 1st page only
Pope, J CLINICAL ETHICS (2012 - Part 2) 1st page only
Pope, Cardozo J Conflict Resolution (2014)
Pope, ASBH Presentation in Houston (Oct. 2015)
Pope, 350 slides from Feb 2017 Guardianship Summit
Volpe & Steinman, Hamline L Rev (2013)
MP3 from ASBH Session (Oct. 2015)
MP3 from Griggins ASBH (Oct. 2015)
Facility & Society Policies
Alameda Health System Policy
American College of Physicians (2012)
American Geriatrics Society (1996) (old)
American Geriatrics Society (2016)
American Medical Association Code of Medical Ethics 2.1.2(f)
Brigham & Women's Hospital
California Hospital (generic)
California Hospital Association (rev 2015)
California Medical Association
Cleveland Clinic
Guam Memorial Hospital Authority (2013)
Highland Hospital of Rochester (2003) (NY)
Kentucky Medical Association (2019)
LACBA & LACMA (2006) (CA)
Lenox Hill (NY)
NY Criminal Justice Identification of Unidentified Patients Model Policy (2017)
NY FHCDA Form 5
Oregon Health & Science University (2014)
Regions Hospital (MN)
San Francisco General
Santa Clara County Medical Association
Santa Clara Valley Medical Center
St. Joseph Health (2017) (CA)
Stanford Hospital
Tehachapi Valley Healthcare District (2008) (CA)
UCLA
University Health System (2015) (San Antonio, TX)
University Hospital (NJ)
Veterans Health Administration (2009)
Veterans Health Administration (2017)
West Virginia State Agency