SURROGATE DECISION-MAKING COMMITTEE
The Surrogate Decision-Making Committee (SDMC) program is an alternative to the court system and is authorized to provide consent for non-emergency major medical treatment and end-of-life care decisions for people who qualify.
Funded by the New York State Justice Center, the SDMC Program helps make medical decisions for people with disabilities that are unable to make these decisions for themselves. Without the SDMC Program, individuals would have to wait months for Surrogate’s Court to make decisions about routines medical procedures.
SDMC also responds to end-of-life cases when DNR and other comfort care order are needed.
Our program consists of volunteer panels who make the decision, providing for quicker, more accessible, cost-free, and personalized decisions on behalf of individuals with disabilities. Empowered Pathways’ SDMC Program covers 14 counties.
The following guidelines, definitions and explanations of the SDMC services are courtesy of the New York State Justice Center for the Protection of People With Special Needs. For more information, please visit their website: Surrogate Decision-Making Committee Services
CAN BE MADE?
Medical, surgical, dental, or diagnostic interventions or procedures which involve:
The use of a general anesthetic
Any significant invasion of bodily integrity requiring an incision or producing substantial pain, discomfort, debilitation, or having a significant recovery period
Significant risk (e.g. colonoscopies, endoscopies, MRIs, CT Scans with contrast)
Withdrawal or withholding of life-sustaining treatment for persons with an intellectual or developmental disability
Any other treatment or procedure for which informed consent is required by law
The following treatment is excluded by law from the SDMC program:
Routine diagnosis or treatment including the administration of routine medications
Dental care performed under a local anesthetic
Emergency medical treatment
Electroconvulsive therapy (ECT)
Withdrawal or discontinuation of life-sustaining medical treatment except as provided in the Health Care Decisions Act for persons with an intellectual or developmental disability
Termination of pregnancy
WHO IS ELIGIBLE?
SDMC considers Major Medical Treatment Decisions and End of Life Care decisions for certain individuals who are unable to provide informed consent and have no authorized, willing, and available surrogate to act on their behalf.
Who is eligible?
Individuals believed to be incapable of providing informed consent, have no surrogate authorized to act on their behalf and:
Currently reside or have formerly resided in a residential program operated, licensed, approved, or funded by the Office for People With Developmental Disabilities (OPWDD), the Office of Mental Health (OMH), or the Office of Addiction Services and Supports (OASAS); or
Currently or previously receive(d) individual support, case management, family care or day programs approved or funded by OPWDD.
End-of-Life Care Decisions
SDMC was granted jurisdiction to provide end-of-life care decisions for individuals with intellectual or developmental disabilities through an amendment to the Health Care Decisions Act in 2008.
When is a person considered to be incapable of providing consent?
If an individual is unable to assess the risks, benefits, and alternatives to a proposed medical treatment, including the risks of non-treatment, they are therefore unable to make an informed decision to consent or refuse such treatment.
Who serves on SDMC panels?
A panel is made up of volunteers appointed by the Justice Center who serve their home communities throughout New York State. A hearing panel must consist of at least three, and no more than four members.
The panels are made up of one member from each of the following categories:
NYS Licensed Health Care Professional (e.g. physician, nurse, clinical social worker)
Former patients or family members of individuals with mental disabilities
Advocate for persons with mental disabilities (e.g. persons with recognized expertise or demonstrated interest in the care and treatment individuals with behavioral health or developmental disabilities)
What determinations must the SDMC panel make?
Panels will make as many as three decisions:
Determination of the individual’s ability to consent to or refuse the proposed major medical treatment decision.
Determination of whether there is an authorized surrogate who is willing and able to consent to or refuse the proposed major medical procedure on behalf of the individual.
Determination of whether the proposed major medical treatment decision is in the best interest of the patient.
The panel makes these decisions in this order to protect the individual’s rights. In all cases, the individual will be seen by the panel or one of its members before a decision is made.