Living wills and substituted judgments

a critical analysis.

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

In the literature three mechanisms are commonly distinguished to make decisions about the care of incompetent patients: A living will, a substituted judgment by a surrogate (who may or may not hold the "power of attorney"), and a best interest judgment. Almost universally, the third mechanism is deemed the worst possible of the three, to be invoked only when the former two are unavailable. In this article, I argue in favor of best interest judgments. The ever more common aversion of best interest judgments entails a risk that health care providers withdraw from the decision-making process, abandoning patients (or their family members) to these most difficult of decisions about life and death. My approach in this article is primarily negative, that is, I criticize the alleged superiority of the living will and substituted judgment. The latter two mechanisms gain their alleged superiority because they are supposedly morally neutral, whereas the best interest judgment entails a value judgment on behalf of the patient. I argue that on closer inspection living wills and substituted judgments are not morally neutral; indeed, they generally rely on best interest judgments, even if those are not made explicit.

Original languageEnglish
Pages (from-to)169-183
Number of pages15
JournalMedicine, Healthcare and Philosophy
Volume4
Issue number2
StatePublished - 2001

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Living Wills
power of attorney
value judgement
decision-making process
family member
Critical Analysis
health care
Lawyers
death
Health Personnel
Decision Making
Patient Care

All Science Journal Classification (ASJC) codes

  • Philosophy
  • Public Health, Environmental and Occupational Health
  • Health(social science)

Cite this

Living wills and substituted judgments : a critical analysis. / Welie, Jos V. M.

In: Medicine, Healthcare and Philosophy, Vol. 4, No. 2, 2001, p. 169-183.

Research output: Contribution to journalArticle

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