Turning failures into successes: A methodological shortcoming in empirical research on surrogate accuracy
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Theoretical Medicine and Bioethics 29 (1):17-26 (2008)
Decision making for incompetent patients is a much-discussed topic in bioethics. According to one influential decision making standard, the substituted judgment standard, a surrogate decision maker ought to make the decision that the incompetent patient would have made, had he or she been competent. Empirical research has been conducted in order to find out whether surrogate decision makers are sufficiently good at doing their job, as this is defined by the substituted judgment standard. This research investigates to what extent surrogates are able to predict what the patient would have preferred in the relevant circumstances. In this paper we address a methodological shortcoming evident in a significant number of studies. The mistake consists in categorizing responses that only express uncertainty as predictions that the patient would be positive to treatment, on the grounds that the clinical default is to provide treatment unless it is refused. We argue that this practice is based on confusion and that it risks damaging the research on surrogate accuracy.
|Keywords||Incompetence Medical decision making Prediction Substituted judgment Surrogate accuracy Uncertainty|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Anthony Wrigley (2011). The Problem of Counterfactuals in Substituted Judgement Decision-Making. Journal of Applied Philosophy 28 (2):169-187.
Greg Clarke, Robert T. Hall & Greg Rosencrance (2004). Physician-Patient Relations: No More Models. American Journal of Bioethics 4 (2):16 – 19.
Susan R. Martyn (2009). Substituted Judgment, Best Interests, and the Need for Best Respect. Cambridge Quarterly of Healthcare Ethics 3 (02):195-.
Elysa R. Koppelman (2002). Dementia and Dignity: Towards a New Method of Surrogate Decision Making. Journal of Medicine and Philosophy 27 (1):65 – 85.
Kristine Bærøe (2010). Patient Autonomy, Assessment of Competence and Surrogate Decision-Making: A Call for Reasonableness in Deciding for Others. Bioethics 24 (2):87-95.
Robert A. Pearlman, Steven H. Miles & Robert M. Arnold (1993). Contributions of Empirical Research to Medical Ethics. Theoretical Medicine and Bioethics 14 (3).
Rosamond Rhodes & Ian Holzman (2004). The Not Unreasonable Standard for Assessment of Surrogates and Surrogate Decisions. Theoretical Medicine and Bioethics 25 (4):367-386.
Linus Broström, The Substituted Judgment Standard. Studies on the Ethics of Surrogate Decision Making.
Mats Johansson & Linus Broström (2012). Empirical Fallacies in the Debate on Substituted Judgment. Health Care Analysis (1):1-9.
Added to index2009-01-28
Total downloads4 ( #272,798 of 1,140,372 )
Recent downloads (6 months)1 ( #140,193 of 1,140,372 )
How can I increase my downloads?