Decision making in health care: limitations of the substituted judgement principle.

Full Abstract

The substituted judgement principle is often recommended as a means of promoting the self-determination of an incompetent individual when proxy decision makers are faced with having to make decisions about health care. This article represents a critical ethical analysis of this decision-making principle and describes practical impediments that serve to undermine its fundamental purpose. These impediments predominantly stem from the informality associated with the application of the substituted judgement principle. It is recommended that the principles upon which decisions are made about health care for another person should be transparent to all those involved in the process. Furthermore, the substituted judgement principle requires greater rigour in its practical application than currently tends to be the case. It may be that this principle should be subsumed as a component of advance directives in order that it fulfils its aim of serving to respect the self-determination of incompetent individuals.

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Author information

Author/s: Bailey, Susan (S);

Affiliation: Faculty of Health and Behavioural Sciences, Deakin University, Geelong, Victoria, Australia. sbailey(-atsign-)deakin.edu.au

Journal and publication information

Publication Type: Journal Article

Journal: Nursing ethics (Nurs Ethics), published in England. (Language: eng)

Reference: 2002-Sep; vol 9 (issue 5) : pp 483-93

Dates: Created 2002/09/19; Completed 2002/11/13; Revised 2004/11/17;

PMID: 12238745, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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