STANDARDS FOR SURROGATE DECISION MAKING

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Presentation transcript:

STANDARDS FOR SURROGATE DECISION MAKING SUBSTITUTED JUDGMENT BEST INTEREST

STANDARDS FOR SURROGATE DECISION MAKING SUBSTITUTED JUDGMENT SURROGATE ATTEMPTS TO REPLICATE FAITHFULLY THE DECISION THAT THE INCAPACITATED PERSON WOULD MAKE IF HE/SHE WERE ABLE TO MAKE A CHOICE SURROGATE LOOKS AT THE DECISION THROUGH THE “VALUE EYES” OF THE INCAPACITATED PERSON GROUNDED IN THE PRINCIPLE OF AUTONOMY BASED UPON DIRECT STATEMENTS BY PATIENT INFERENCES FROM VALUE CHOICES OF PATIENT SUBSTITUTED JUDGMENT STANDARD IS PREFERABLE BUT BEST INTEREST STANDARD IS PERMITTED AND OFTEN NECESSARY

STANDARDS FOR SURROGATE DECISION MAKING BEST INTERESTS SURROGATE MAKES THE DECISION, FROM AN OBJECTIVE STANDPOINT, WHICH APPEARS TO PROMOTE A PATIENT’S GOOD WITHOUT REFERENCE TO THE INCAPACITATED PATIENT’S ACTUAL OR SUPPOSED PREFERENCES WEIGHING BENEFITS AND BURDENS FROM THE STANDPOINT OF A “REASONABLE” PERSON LOOKING AT THE CLINICAL OUTCOMES “REASONABLE” = SELF-REFLECTIVE, RELATIVELY UNBIASED, ATTEMPTING FACT-BASED OBJECTIVITY, SETTING ASIDE SELF-INTEREST GROUNDED IN THE PRINCIPLE OF BENEFICENCE