Changing the Question.
Changing the Question.
复制标题
改变问题。
DOI：
10.1002/hast.988
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
D. Brudney
中科院分区：
文献类型：
--
作者：
D. Brudney
Jack, who is seventy-five years old, is in the hospital with a terminal condition that has undermined his cognitive faculties. He has left no advance directive and has never had a conversation in which he made his treatment wishes remotely clear. Yet now, a treatment decision must be made, and in modern American medicine, the treatment decision for Jack is supposed to be made by a surrogate decision-maker, who is supposed to use a decision-making standard known as "substituted judgment." According to the substituted judgment standard, Jack's surrogate decision-maker, his wife, is supposed to decide on his treatment by determining what Jack would do if he did have decisional capacity. That is, she is supposed to answer the question, what would the patient choose? I will argue that this is the wrong question to ask because when the question has a determinate answer, that answer is sometimes not sufficiently connected to the value that is supposed to make the question morally salient, and because sometimes, perhaps often, there is no determinate answer to the question of what the patient would choose. Jointly, these two problems suggest the need for a different question.
