Proxy Decision Making for Incompetent Patients: An Ethical and Empirical Analysis
Emanuel, Ezekiel J.
Emanuel, Linda L.
JAMA. 1992 Apr 15; 267(15): 2067-2071.
Conclusions: The recent trend has been to rely on proxy decision making for incompetent patients. Support for proxy decision making has failed to acknowledge the growing body of ethical and empirical research suggesting that proxy decision making fails to realize its objective of promoting the patient's medical care preferences. There are several potential solutions: revision of the justification for and expectations of proxies, augmentation of proxy designation with instructional directives, or relegation to communities of decisions regarding the care of incompetent patients. These solutions are not necessarily mutually exclusive. And while there are objections to each solution, the persistent failing of proxy decision making as currently justified and practiced requires, as Justice Handler of the New Jersey Supreme Court put it, that these solutions be given greater consideration in the near future.
Advance Directives; Aged; Allowing to Die; Competence; Consensus; Consent; Decision Making; Economics; Empirical Research; Ethical Analysis; Evaluation; Evaluation Studies; Family Members; Family Relationship; Informed Consent; Justice; Life; Moral Policy; Patients; Persistent Vegetative State; Proxy; Public Policy; Quality of Life; Research; Resuscitation; Resuscitation Orders; Review; Standards; Terminal Care; Third Party Consent; Values; Withholding Treatment;
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Emanuel, Ezekiel J.; Emanuel, Linda L. (1992-04-15)Conclusions: The recent trend has been to rely on proxy decision making for incompetent patients. Support for proxy decision making has failed to acknowledge the growing body of ethical and empirical research suggesting that ...
Emanuel, Ezekiel J. (1988-01-23)Emanuel criticizes the New Jersey Supreme Court's use of the substituted judgement standard, first laid down by the court in its 1976