A Mixed Judgment Standard for Surrogate Decision-Making. Issue 4 (5th November 2022)

• Record Type: Journal Article
• Authors: Stout, Nathan
• Is Part Of: Journal of medicine and philosophy. Volume 47:Issue 4(2022)
• Page Start: 540
• Page End: 548
• Publication Date: 2022-11-05
• Subjects: decision-making capacity -- substituted judgment -- surrogate decision-making; Medicine -- Philosophy -- Periodicals; Medical ethics -- Periodicals; Ethics, Medical -- Periodicals; Philosophy, Medical -- Periodicals; 616.001
• DOI: 10.1093/jmp/jhac016
• Languages: English
• ISSNs: 0360-5310

Abstract

Abstract: The Substituted Judgment Standard (SJS) for surrogate decision-making dictates that a surrogate, when making medical decisions on behalf of an incapacitated patient, ought to make the decision that the patient would have made if the patient had decisional capacity. Despite its intuitive appeal, however, SJS has been the target of a variety of criticisms. Most objections to SJS appeal to epistemic difficulties involved in determining what a patient would have decided in a given case. In this article, I offer an alternative standard for surrogate decision-making that avoids these difficulties. I then offer an account of its theoretical underpinnings which shows that it preserves the central moral justification for SJS, namely, respect for patient autonomy.