Narrative review and criticize of surrogate decision-making in liberal medical ethics

The right of patients to make decisions about their medical care, based on informed consent rule and the principle of respect for autonomy rooted from philosophy of liberalism. Patients with capacity are responsible for decision-making, but in those lacking capacity, a surrogate decision maker is needed. This process consisted of three parts: choosing surrogate decision maker, how to make decision and its criteria, if they founded on the intellectual foundations of liberalism, will faced with the challenges, so, must be sought the its solution ways in other philosophical systems. This narrative research tries to analyze and criticize the process of surrogacy decision making based on theoretical essentials of liberalism, meanwhile descript epistemic sources of liberalism. In conclusion, although, medical ethics based on liberalism principles has been designed in a structured manner and can resolve some problems of ethical decisions in medicine, could be however faced with serious challenges.