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Some comments on the substituted judgement standard.

Egonsson, Dan LU (2010) In Medicine, Health Care and Philosophy 13. p.33-40
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Medicine, Health Care and Philosophy
volume
13
pages
33 - 40
publisher
Springer
external identifiers
  • wos:000273318000005
  • pmid:19234760
  • scopus:77949503190
ISSN
1572-8633
DOI
10.1007/s11019-009-9194-y
language
English
LU publication?
yes
id
9c065423-b84e-483f-94f1-6b5fce5c49c3 (old id 1302308)
date added to LUP
2009-03-27 13:04:52
date last changed
2018-05-29 11:31:21
@article{9c065423-b84e-483f-94f1-6b5fce5c49c3,
  abstract     = {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.},
  author       = {Egonsson, Dan},
  issn         = {1572-8633},
  language     = {eng},
  pages        = {33--40},
  publisher    = {Springer},
  series       = {Medicine, Health Care and Philosophy},
  title        = {Some comments on the substituted judgement standard.},
  url          = {http://dx.doi.org/10.1007/s11019-009-9194-y},
  volume       = {13},
  year         = {2010},
}