The Different Moral Bases of Patient and Surrogate Decision‐Making

Hastings Center Report 48 (1):37-41 (2018)
  Copy   BIBTEX

Abstract

My topic is a problem with our practice of surrogate decision-making in health care, namely, the problem of the surrogate who is not doing her job—the surrogate who cannot be reached or the surrogate who seems to refuse to understand or to be unable to understand the clinical situation. The analysis raises a question about the surrogate who simply disagrees with the medical team. One might think that such a surrogate is doing her job—the team just doesn't like how she is doing it. My analysis raises the question of whether she should be overridden. In approaching this problem, I focus not on the range of difficulties in practice but on the underlying moral conceptual issue. My concern will be to show that the moral values that underpin patient decision-making are fundamentally different from those that underpin surrogate decision-making. Identifying the distinctions will set parameters for any successful solution to the “Who should decide?” question. A patient has a specific kind of moral right to make her own medical decisions. A surrogate has no analogous moral right to decide for someone else. We want the surrogate to make the decision because we believe that she has a relevant epistemological advantage over anyone else on the scene. If and when she has no such advantage or if she refuses or is unable to use it, then there might not be sufficient reason to let her be the decision-maker.

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 76,297

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Dementia and dignity: Towards a new method of surrogate decision making.Elysa R. Koppelman - 2002 - Journal of Medicine and Philosophy 27 (1):65 – 85.
The Confucian bioethics of surrogate decision making: Its communitarian roots.Ruiping Fan - 2011 - Theoretical Medicine and Bioethics 32 (5):301-313.
Love as a Regulative Ideal in Surrogate Decision Making.Erica Lucast Stonestreet - 2014 - Journal of Medicine and Philosophy 39 (5):523-542.
Deciding for the Incompetent.Eric Vogelstein - 2017 - In John K. Davis (ed.), Ethics at the End of Life: New Issues and Arguments. New York: Routledge. pp. 108-125.
The Theory and Practice of Surrogate Decision‐Making.David Wendler - 2017 - Hastings Center Report 47 (1):29-31.

Analytics

Added to PP
2018-02-19

Downloads
22 (#522,071)

6 months
1 (#450,425)

Historical graph of downloads
How can I increase my downloads?

Author's Profile

Daniel Brudney
University of Chicago

References found in this work

Agency and authenticity: Which value grounds patient choice?Daniel Brudney & John Lantos - 2011 - Theoretical Medicine and Bioethics 32 (4):217-227.
The value of autonomy.Robert Young - 1982 - Philosophical Quarterly 32 (126):35-44.
Hospital Ethics Committees: Is There a Role?Robert M. Veatch - 1977 - Hastings Center Report 7 (3):22-25.

Add more references