Substituted Judgment

An Ethical Façade? Medical Students' Miscomprehensions of Substituted Judgment

BACKGROUND We studied how well first-year medical students understand and apply the concept of substituted judgment, following a course on clinical ethics. METHOD Students submitted essays on one of three ethically controversial scenarios presented in class. One scenario involved a patient who had lost decisional capacity. Through an iterative process of textual analysis, the essays were stud...

Resurrecting autonomy during resuscitation--the concept of professional substituted judgment.

The urgency of the resuscitation and the impaired ability of the patient to make a reasonable autonomous decision both conspire against adequate consideration of the principles of medical ethics. Informed consent is usually not possible for these reasons and this leads many to consider that consent is not required for resuscitation, because resuscitation brings benefit and prevents harm and bec...

Medical decisionmaking for incompetent persons: the Massachusetts substituted judgment model.

Gender-dependence of substituted judgment on quality of life in patients with dementia

BACKGROUND Substituted judgment asks the proxy to decide what the patient would have decided, had he or she been competent. It is unclear whether substituted judgment of the patient's quality of life can serve as a surrogate measure in patients with dementia. METHODS 212 patients with dementia and their proxies were interviewed in their homes. Dementia syndrome was characterized with cognitiv...

Falling off the vine: legal fictions and the doctrine of substituted judgment.