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    This article clarifies trauma-informed ethics consultation by addressing disagreements in life-sustaining treatment decisions for neurologically impaired patients. It refines the role of surrogate decision-makers and explores ethically acceptable options in these complex cases.

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    Area of Science:

    • Medical Ethics
    • Bioethics
    • Clinical Ethics Consultation

    Background:

    • Disagreements arise between surrogate decision-makers and clinical teams regarding life-sustaining therapies for severely neurologically impaired patients.
    • Fiester's work proposes trauma-informed ethics consultation prioritizing surrogate decision-makers' preferences.

    Purpose of the Study:

    • To respond to Fiester's critique and clarify the authors' account of trauma-informed ethics consultation.
    • To identify areas for further research in trauma-informed ethics consultation theory and practice.
    • To refine the understanding of surrogate decision-maker roles and ethically acceptable options in futility disputes.

    Main Methods:

    • Critical analysis and scholarly response to Fiester's article.
    • Conceptual clarification of ethics consultation processes, methods, and content.
    • Evaluation of the role of ethically acceptable options within trauma-informed ethics consultation.

    Main Results:

    • The authors clarify their "modest" proposal for trauma-informed ethics consultation.
    • Distinctions between ethics consultation process, methods, and content are highlighted for enhancement.
    • The appropriate role of "ethically acceptable options" requires further evaluation.

    Conclusions:

    • Further research is needed to advance trauma-informed ethics consultation.
    • Conceptualizations of trauma-informed care are relevant to ethics consultation development.
    • Refined approaches are necessary for managing disagreements in life-sustaining treatment decisions.