Document Detail


Some comments on the substituted judgement standard.
MedLine Citation:
PMID:  19234760     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
On a traditional interpretation of the substituted judgement standard (SJS) a person who makes treatment decisions on behalf of a non-competent patient (e.g. concerning euthanasia) ought to decide as the patient would have decided had she been competent. I propose an alternative interpretation of SJS in which the surrogate is required to infer what the patient actually thought about these end-of-life decisions. In clarifying SJS it is also important to differentiate the patient's consent and preference. If SJS is part of an autonomy ideal of the sort found in Kantian ethics, consent seems more important than preference. From a utilitarian perspective a preference-based reading of SJS seems natural. I argue that the justification of SJS within a utilitarian framework will boil down to the question whether a non-competent patient can be said to have any surviving preferences. If we give a virtue-ethical justification of SJS the relative importance of consent and preferences depends on which virtue one stresses--respect or care. I argue that SJS might be an independent normative method for extending the patient's autonomy, both from a Kantian and a virtue ethical perspective.
Authors:
Dan Egonsson
Publication Detail:
Type:  Journal Article     Date:  2009-02-21
Journal Detail:
Title:  Medicine, health care, and philosophy     Volume:  13     ISSN:  1572-8633     ISO Abbreviation:  Med Health Care Philos     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-05     Completed Date:  2010-03-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815900     Medline TA:  Med Health Care Philos     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  33-40     Citation Subset:  E; IM    
Affiliation:
Department of Philosophy, Lund University, Kungshuset 22222, Lund, Sweden. Dan.Egonsson@fil.lu.se
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MeSH Terms
Descriptor/Qualifier:
Decision Making*
Ethical Theory
Euthanasia, Active
Humans
Judgment*
Legal Guardians
Mental Competency*
Philosophy, Medical*
Religion

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