The not unreasonable standard for assessment of surrogates and surrogate decisions

Theoretical Medicine and Bioethics 25 (4):367-386 (2004)
Abstract
Standard views on surrogate decision making present alternative ideal models of what ideal surrogates should consider in rendering a decision. They do not, however, explain the physician''s responsibility to a patient who lacks decisional capacity or how a physician should regard surrogates and surrogate decisions. The authors argue that it is critical to recognize the moral difference between a patient''s decisions and a surrogate''s and the professional responsibilities implied by that distinction. In every case involving a patient who lacks decisional capacity, physicians and the treatment team have to make judgments about the appropriateness of both the surrogate and the surrogate''s decision. They have to assess the surrogate''s decisional capacity and attitude toward the patient as well as the reasons that support the surrogate''s decision. This paper provides a model for acceptable surrogate decisions and a standard for blocking inappropriate surrogates. Only decisions based on widely shared reasons are allowable for surrogate refusal of highly beneficial treatment.
Keywords assessment  autonomy  best interest  decisional capacity  decisions  fiduciary responsibility  professional responsibility  reasonable person  reasons  substituted judgment  surrogate
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DOI 10.1007/s11017-004-3138-6
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References found in this work BETA
What We Owe to Each Other.Thomas Scanlon - 1998 - Belknap Press of Harvard University Press.
Bioethics: A Return to Fundamentals.Bernard Gert - 1997 - Oxford University Press.

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Citations of this work BETA
Rethinking Research Ethics.Rosamond Rhodes - 2005 - American Journal of Bioethics 5 (1):7 – 28.
Laying Futility to Rest.Michael Nair-Collins - 2015 - Journal of Medicine and Philosophy 40 (5):554-583.
Rethinking Research Ethics.Rosamond Rhodes - 2010 - American Journal of Bioethics 10 (10):19-36.

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