Groups of clinicians and researchers are trying to better understand how to best support surrogate decision-making in these "unbefriended
older adults." The Ethics Committee of the American Geriatrics Society recently published a position statement on this (Farrell et al., 2016).
Sometimes the patient is alone without family, such as an "unbefriended
elderly" or "unrepresented patient." (39) The mediation is largely with non-patient advocates because capacitated adult patients have the legal right to accept or reject medical alternatives even if their decisions are thought to be wrong by others.
0 Lord our God, help tus tear their soldiers to bloody shreds with our shells; help us to cover their smiling fields with the paler forms of their patriot dead; help us to drown the thunder of the guns with the shrieks of their wounded, writhing in pain; help us to lay waste their humble homes with a hurricane of fire; help us to wring the hearts of their unoffending widows with unavailing grief; help us to turn them out roofless with their little children to wander unbefriended
the wastes of their desolate land in rags and hunger and thirst ...