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Substituted consent : from lunatics to corpses

journal contribution
posted on 01.05.2007, 00:00 authored by Danuta MendelsonDanuta Mendelson
This analysis traces the origins and evolution of the doctrine of surrogate or substituted judgment, especially its application to medical treatment, including non-therapeutic sterilisation, decisions regarding life and death choices, and more recently, removal of sperm or eggs from incompetent, dying or dead males and females. It argues that the doctrine, which has been acknowledged to be a legal fiction, has an effect of devolving legal and moral responsibility for life and death choices, as well as non-consensual, non-beneficial intrusive procedures, from the competent decision-makers to the incompetent patient. It focuses on the subjective nature of the substituted judgment standard; the problematic nature of evidence propounded to establish the putative choices of the incompetent person; lack of transparency relating to the conflict of interest in the process of substituted judgment decision-making; and the absence of voluntariness, which is an essential element of a valid consent.

History

Journal

Journal of law and medicine

Volume

14

Issue

4

Pagination

449 - 462

Publisher

LawBook Co.

Location

North Ryde, NSW

ISSN

1320-159X

Language

eng

Publication classification

C1 Refereed article in a scholarly journal; C Journal article

Copyright notice

2007, LawBook Co.

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