Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
The authors of this paper, Clarifying Substituted Judgment: The Endorsed Life Approach, alleged that respecting patient's autonomy is the primary goal of the current clinical practice.1 For incapacitated patients without definitive advance directives or with no advance directives at all, making decisions based on the substituted judgement standard (SJS) was regarded by the author as being widely accepted as the best way to pay due respect to the autonomy of such patients. According to the standard interpretation, the surrogate should make the decision that the incapacitated patient would have made if competent. However, there are critics who have argued that it is practically difficult to follow SJS and that the standard is theoretically unsound. It follows that SJS may need to be “significantly revised or abandoned altogether”1, but it has already been a standard part of clinical practice. The author believed that the challenges of the critics do not stem from SJS itself but from how it has been interpreted, and that the challenges can be met by adopting a better interpretation that is the endorsed life approach (ELA). According to this approach, the surrogate should make the decision in …
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
- Feature article
Read the full text or download the PDF:
Other content recommended for you
- Advance decisions in dementia: when the past conflicts with the present
- Practising what we preach: clinical ethicists’ professional perspectives and personal use of advance directives
- Clarifying substituted judgement: the endorsed life approach
- In the patient’s best interest: appraising social network site information for surrogate decision making
- Public knowledge, preferences and experiences about medical substitute decision-making: a national cross-sectional survey
- Substituted decision making and the dispositional choice account
- Doctors’ perspectives on adhering to advance care directives when making medical decisions for patients: an Australian interview study
- Adverse consequences of article 12 of the UN Convention on the Rights of Persons with Disabilities for persons with mental disabilities and an alternative way forward
- Deciding on behalf of others: a population survey on procedural preferences for surrogate decision-making
- ‘In a twilight world’? Judging the value of life for the minimally conscious patient