Document Detail


Patient autonomy, assessment of competence and surrogate decision-making: a call for reasonableness in deciding for others.
MedLine Citation:
PMID:  18644014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this paper, I address some of the shortcomings of established clinical ethics centring on personal autonomy and consent and what I label the Doctrine of Respecting Personal Autonomy in Healthcare. I discuss two implications of this doctrine: 1) the practice for treating patients who are considered to have borderline decision-making competence and 2) the practice of surrogate decision-making in general. I argue that none of these practices are currently aligned with respectful treatment of vulnerable individuals. Because of 'structural arbitrariness' in the whole process of how we assess decision-making competence, this area is open to disrespectful treatment of people. The practice of surrogate decision- making on the basis of a single person's judgment is arguably not consistent with ethical and political requirements derived from the doctrine itself. In response to the inadequacies of the doctrine, I suggest a framework for reasonableness in surrogate decision-making which might allow practice to avoid the problems above. I conclude by suggesting an extended concept of Patient Autonomy which integrates both personal autonomy and the regulative idea of morality that is required by reasonableness in deciding for non-competent others.
Authors:
Kristine Baer?e
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-07-17
Journal Detail:
Title:  Bioethics     Volume:  24     ISSN:  1467-8519     ISO Abbreviation:  Bioethics     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-06     Completed Date:  2010-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704792     Medline TA:  Bioethics     Country:  England    
Other Details:
Languages:  eng     Pagination:  87-95     Citation Subset:  E; IM    
Affiliation:
Department of Public Health and Primary Health Care, University of Bergen, Norway. kristine.baroe@isf.uib.no
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MeSH Terms
Descriptor/Qualifier:
Decision Making / ethics*
Humans
Mental Competency*
Personal Autonomy*
Third-Party Consent / ethics*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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