Holistic determination for oneself: A new paradigm for self-determination at end of life.
Holistic determination for oneself: A new paradigm for self-determination at end of life.
复制标题
自我整体决定：临终自我决定的新范式。
DOI：
10.1017/s0008197313000743
复制
发表时间：
2013
影响因子：
1.5
通讯作者：
A. Samanta
中科院分区：
文献类型：
--
作者：
J. Samanta;A. Samanta
由有能力的成年人自主决定是医疗法的基石。我们认为，康德的自治作为最重要的模式，在生命的尽头自决的应用是值得怀疑的，因为它未能捕捉到微妙的细微差别的决策在这种情况下。我们提出了一个替代模型，我们称之为“整体决定自己”，并将其视为传统康德式结构的潜在竞争者。整体决定的范式是在子决定的基础上概念化的，这些子决定合并形成最终决定。这种模式提供了一个独特的视角，是多轴（基于决策的层次）和多维（基于一个持续的时间相互关系和综合综合的各级决策）。自我的整体决定提供了一个范例，是锻炼，普遍和最佳的自决在生命的尽头。
Autonomous self-determination by competent adults is a cornerstone of medical law. We argue that the application of Kantian autonomy as the paramount model for self-determination at end of life is questionable as it fails to capture subtler nuances of decision-making in this context. We propose an alternative model which we term ‘holistic determination for oneself’ and posit this as a potential contender to the traditional Kantian construct. The paradigm of holistic determination is conceptualised on the basis of sub-determinations which coalesce to form the final determination. This paradigm offers a unique perspective that is multi-axial (based on the levels of decision-making) and multi-dimensional (based on an on-going temporal inter-relational and integrative synthesis of decisions at all levels). Holistic determination for oneself offers a paradigm that is tempered, universal and optimal for self-determination at end of life.