David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Applied Philosophy 28 (2):169-187 (2011)
The standard by which we apply decision-making for those unable to do so for themselves is an important practical ethical issue with substantial implications for the treatment and welfare of such individuals. The approach to proxy or surrogate decision-making based upon substituted judgement is often seen as the ideal standard to aim for but suffers from a need to provide a clear account of how to determine the validity of the proxy's judgements. Proponents have responded to this demand by providing the truth-conditions for the substituted judgement in terms of counterfactual reasoning using a possible worlds semantics. In this paper, I show how these underpinnings fail to support the substituted judgement approach as a reasonable standard for decision-making. Firstly, I show how this counterfactual element has been poorly interpreted. I then explain how various accounts have failed to reflect problems and limitations associated with providing an interpretation of their truth-conditions using counterfactuals. Finally, I argue that, even when we attend to the initial problems of providing a counterfactual analysis, it still deeply problematic as a means of determining the validity of substituted judgements for two main reasons. Firstly, making determinate judgements as to the truth-value of these judgements will often not be possible and, secondly, there is a strong requirement when interpreting many counterfactual claims to charitably accede to their being true. I conclude that substituted judgements, as interpreted through counterfactual reasoning and possible worlds semantics, do not therefore provide an adequate standard for surrogate decision-making.
|Keywords||No keywords specified (fix it)|
|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
Anthony Wrigley (2015). Moral Authority and Proxy Decision-Making. Ethical Theory and Moral Practice 18 (3):631-647.
Similar books and articles
Mats Johansson & Linus Broström (2011). Counterfactual Reasoning in Surrogate Decision Making – Another Look. Bioethics 25 (5):244-249.
Linus Broström, The Substituted Judgment Standard. Studies on the Ethics of Surrogate Decision Making.
Mats Johansson & Linus Broström (2008). Turning Failures Into Successes: A Methodological Shortcoming in Empirical Research on Surrogate Accuracy. Theoretical Medicine and Bioethics 29 (1):17-26.
Mats Johansson & Linus Broström (2012). Empirical Fallacies in the Debate on Substituted Judgment. Health Care Analysis (1):1-9.
Catherine Lowy (1988). The Doctrine of Substituted Judgement in Medical Decision Making. Bioethics 2 (1):15–21.
Susan R. Martyn (2009). Substituted Judgment, Best Interests, and the Need for Best Respect. Cambridge Quarterly of Healthcare Ethics 3 (2):195.
S. Barker (2003). A Dilemma for the Counterfactual Analysis of Causation. Australasian Journal of Philosophy 81 (1):62 – 77.
Robert A. Pearlman, Steven H. Miles & Robert M. Arnold (1993). Contributions of Empirical Research to Medical Ethics. Theoretical Medicine and Bioethics 14 (3).
David R. Mandel (2003). Effect of Counterfactual and Factual Thinking on Causal Judgements. Thinking and Reasoning 9 (3):245 – 265.
Marc Pauly & Martin van Hees (2006). Logical Constraints on Judgement Aggregation. Journal of Philosophical Logic 35 (6):569 - 585.
Robert S. Wigton (1996). Social Judgement Theory and Medical Judgement. Thinking and Reasoning 2 (2 & 3):175 – 190.
Mark G. Kuczewski (1999). Commentary: Narrative Views of Personal Identity and Substituted Judgment in Surrogate Decision Making. Journal of Law, Medicine & Ethics 27 (1):32-36.
Leon Culbertson (2012). Pandora Logic: Rules, Moral Judgement and the Fundamental Principles of Olympism. Sport, Ethics and Philosophy 6 (2):195-210.
Yujin Nagasawa (2008). Proxy Consent and Counterfactuals. Bioethics 22 (1):16–24.
Alan Schwartz (2008). Medical Decision Making: A Physician's Guide. Cambridge University Press.
Added to index2010-12-22
Total downloads12 ( #234,034 of 1,777,884 )
Recent downloads (6 months)1 ( #291,290 of 1,777,884 )
How can I increase my downloads?