Clarifying substituted judgement: the endorsed life approach: Table 1

Journal of Medical Ethics 41 (9):723-730 (2015)
  Copy   BIBTEX

Abstract

A primary goal of clinical practice is to respect patient autonomy. To promote this goal for patients who have lost the ability to make their own decisions, commentators recommend that surrogates make their treatment decisions based on the substituted judgment standard. This standard is commonly interpreted as directing surrogates to make the decision the patient would have made in the circumstances, if the patient were competent. However, recent commentators have argued that this approach—attempting to make the decision the patient would have made if competent—is theoretically problematic, practically infeasible, and ignores the interests of the patient9s family and loved ones. These commentators conclude that the substituted judgment standard should be revised significantly, or abandoned altogether. While this response would avoid the cited problems, it also would require substantial changes to clinical practice and would raise significant problems of its own. The present paper thus considers the possibility that the criticisms do not point to problems with the substituted judgment standard itself; instead, they point to problems with the way it is most commonly interpreted. This analysis suggests that the substituted judgment standard need not be dramatically revised or abandoned. Instead, it should be interpreted in a way that effectively promotes respect for the autonomy of incompetent patients. The ‘endorsed life’ interpretation described here helps clinicians and surrogates to achieve this important goal. To clarify this approach, we explain how it differs from three other recently proposed alternatives to the standard interpretation of the substituted judgment standard.

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 89,491

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

Substituted misjudgement.J. A. Woo & K. M. Prager - 2009 - Clinical Ethics 4 (4):208-210.
Some comments on the substituted judgement standard.Dan Egonsson - 2010 - Medicine, Health Care and Philosophy 13 (1):33-40.
The sanctity of life and substituted judgement: the case of Baby J.S. I. Hornett - 1991 - Ethics and Medicine: A Christian Perspective on Issues in Bioethics 7 (2):2.
Intentionalism and the Argument from No Common Content.Michael Tye - 2007 - Philosophical Perspectives 21 (1):589-613.
The Yoga sūtra of Patañjali: a scientific exposition with original Sanskrit text.Shilaja Nagendra - 1996 - Delhi: Published by Clarion Books associated with Hind Pocket Books. Edited by Vinoda Verma.

Analytics

Added to PP
2015-09-03

Downloads
12 (#918,004)

6 months
3 (#428,620)

Historical graph of downloads
How can I increase my downloads?

References found in this work

Principles of biomedical ethics.Tom L. Beauchamp - 1979 - New York: Oxford University Press. Edited by James F. Childress.
Harm to Self.Joel Feinberg - 1986 - Oxford University Press USA.
Deciding for Others.Gerald Dworkin, Allen E. Buchanan & Dan W. Brock - 1991 - Philosophical Quarterly 41 (162):118.
What about the Family?John Hardwig - 1990 - Hastings Center Report 20 (2):5.
What About the Family?John Hardwig - 1990 - Hastings Center Report 20 (2):5-10.

View all 18 references / Add more references