Journal of Medical Ethics:medethics-2020-107154 (forthcoming)

Substituted judgment has increasingly become the accepted standard for rendering decisions for incapacitated adults in the USA. A broad exception exists with regard to patients with diminished capacity secondary to depressive disorders, as such patients’ previous wishes are generally not honoured when seeking to turn down life-preserving care or pursue aid-in-dying. The result is that physicians often force involuntary treatment on patients with poor medical prognoses and/or low quality of life as a result of their depressive symptoms when similarly situated incapacitated patients without such depressive symptoms would have their previous wishes honoured via substituted judgment. This commentary argues for reconsidering this approach and for using a substituted judgment standard for a subset of EMP/LQL patients seeking death.
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DOI 10.1136/medethics-2020-107154
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The Concept of Rational Suicide.David J. Mayo - 1986 - Journal of Medicine and Philosophy 11 (2):143-155.
Bound to Treatment: The Ulysses Contract.Rebecca Dresser - 1984 - Hastings Center Report 14 (3):13-16.

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