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Turning failures into successes: a methodological shortcoming in empirical research on surrogate accuracy.

Johansson, Mats LU and Broström, Linus LU (2008) In Theoretical Medicine and Bioethics 29(1). p.17-26
Abstract
Decision making for incompetent patients is a much-discussed topic in bioethics. According to one influential decision making standard, the substituted judgment standard, a surrogate decision maker ought to make the decision that the incompetent patient would have made, had he or she been competent. Empirical research has been conducted in order to find out whether surrogate decision makers are sufficiently good at doing their job, as this is defined by the substituted judgment standard. This research investigates to what extent surrogates are able to predict what the patient would have preferred in the relevant circumstances. In this paper we address a methodological shortcoming evident in a significant number of studies. The mistake... (More)
Decision making for incompetent patients is a much-discussed topic in bioethics. According to one influential decision making standard, the substituted judgment standard, a surrogate decision maker ought to make the decision that the incompetent patient would have made, had he or she been competent. Empirical research has been conducted in order to find out whether surrogate decision makers are sufficiently good at doing their job, as this is defined by the substituted judgment standard. This research investigates to what extent surrogates are able to predict what the patient would have preferred in the relevant circumstances. In this paper we address a methodological shortcoming evident in a significant number of studies. The mistake consists in categorizing responses that only express uncertainty as predictions that the patient would be positive to treatment, on the grounds that the clinical default is to provide treatment unless it is refused. We argue that this practice is based on confusion and that it risks damaging the research on surrogate accuracy. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Theoretical Medicine and Bioethics
volume
29
issue
1
pages
17 - 26
publisher
Springer Netherlands
external identifiers
  • WOS:000255035000002
  • PMID:18392948
  • Scopus:42449103434
ISSN
1386-7415
DOI
10.1007/s11017-008-9059-z
language
English
LU publication?
yes
id
db691926-028a-4574-a955-4824c355178c (old id 1147691)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18392948?dopt=Abstract
date added to LUP
2008-05-08 11:52:02
date last changed
2016-10-13 04:34:21
@misc{db691926-028a-4574-a955-4824c355178c,
  abstract     = {Decision making for incompetent patients is a much-discussed topic in bioethics. According to one influential decision making standard, the substituted judgment standard, a surrogate decision maker ought to make the decision that the incompetent patient would have made, had he or she been competent. Empirical research has been conducted in order to find out whether surrogate decision makers are sufficiently good at doing their job, as this is defined by the substituted judgment standard. This research investigates to what extent surrogates are able to predict what the patient would have preferred in the relevant circumstances. In this paper we address a methodological shortcoming evident in a significant number of studies. The mistake consists in categorizing responses that only express uncertainty as predictions that the patient would be positive to treatment, on the grounds that the clinical default is to provide treatment unless it is refused. We argue that this practice is based on confusion and that it risks damaging the research on surrogate accuracy.},
  author       = {Johansson, Mats and Broström, Linus},
  issn         = {1386-7415},
  language     = {eng},
  number       = {1},
  pages        = {17--26},
  publisher    = {ARRAY(0xa70c030)},
  series       = {Theoretical Medicine and Bioethics},
  title        = {Turning failures into successes: a methodological shortcoming in empirical research on surrogate accuracy.},
  url          = {http://dx.doi.org/10.1007/s11017-008-9059-z},
  volume       = {29},
  year         = {2008},
}