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Counterfactual reasoning in surrogate decision making – another look

Johansson, Mats LU orcid and Broström, Linus LU (2011) In Bioethics 25(5). p.244-249
Abstract
Incompetent patients need to have someone else make decisions on their behalf. According to the Substituted Judgment Standard the surrogate decision maker ought to make the decision that the patient would have made, had he or she been competent. Objections have been raised against this traditional construal of the standard on the grounds that it involves flawed counterfactual reasoning, and amendments have been suggested within the framework of possible worlds semantics. The paper shows that while this approach may circumvent the alleged problem, the way it has so far been elaborated reflects insufficient understanding of the moral underpinnings of the idea of substituted judgment. Proper recognition of these moral underpinnings has... (More)
Incompetent patients need to have someone else make decisions on their behalf. According to the Substituted Judgment Standard the surrogate decision maker ought to make the decision that the patient would have made, had he or she been competent. Objections have been raised against this traditional construal of the standard on the grounds that it involves flawed counterfactual reasoning, and amendments have been suggested within the framework of possible worlds semantics. The paper shows that while this approach may circumvent the alleged problem, the way it has so far been elaborated reflects insufficient understanding of the moral underpinnings of the idea of substituted judgment. Proper recognition of these moral underpinnings has potentially far-reaching implications for our normative assumptions about accuracy and objectivity in surrogate decision making. (Less)
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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Bioethics
volume
25
issue
5
pages
244 - 249
publisher
Wiley-Blackwell
external identifiers
  • wos:000290494000003
  • scopus:79956074487
  • pmid:19874290
ISSN
0269-9702
DOI
10.1111/j.1467-8519.2009.01768.x
project
Research on decisionally incapacitated individuals. A legal study of the Act concerning the Ethical Review of Research Involving Humans, and its application
language
English
LU publication?
yes
id
97783e9a-c993-43aa-8663-ac04414eeaa4 (old id 1451995)
date added to LUP
2016-04-01 10:02:46
date last changed
2020-01-05 04:19:43
@article{97783e9a-c993-43aa-8663-ac04414eeaa4,
  abstract     = {Incompetent patients need to have someone else make decisions on their behalf. According to the Substituted Judgment Standard the surrogate decision maker ought to make the decision that the patient would have made, had he or she been competent. Objections have been raised against this traditional construal of the standard on the grounds that it involves flawed counterfactual reasoning, and amendments have been suggested within the framework of possible worlds semantics. The paper shows that while this approach may circumvent the alleged problem, the way it has so far been elaborated reflects insufficient understanding of the moral underpinnings of the idea of substituted judgment. Proper recognition of these moral underpinnings has potentially far-reaching implications for our normative assumptions about accuracy and objectivity in surrogate decision making.},
  author       = {Johansson, Mats and Broström, Linus},
  issn         = {0269-9702},
  language     = {eng},
  number       = {5},
  pages        = {244--249},
  publisher    = {Wiley-Blackwell},
  series       = {Bioethics},
  title        = {Counterfactual reasoning in surrogate decision making – another look},
  url          = {http://dx.doi.org/10.1111/j.1467-8519.2009.01768.x},
  doi          = {10.1111/j.1467-8519.2009.01768.x},
  volume       = {25},
  year         = {2011},
}