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

Bailey, Susan 2002, Decision making in health care: limitations of the substituted judgement principle, Nursing ethics, vol. 9, no. 5, pp. 483-493, doi: 10.1191/0969733002ne538oa.

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Title Decision making in health care: limitations of the substituted judgement principle
Author(s) Bailey, Susan
Journal name Nursing ethics
Volume number 9
Issue number 5
Start page 483
End page 493
Publisher Arnold Publishers
Place of publication London, England
Publication date 2002
ISSN 0969-7330
Keyword(s) decision making
health care
substituted judgement
Summary 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.
Language eng
DOI 10.1191/0969733002ne538oa
Field of Research 220305 Ethical Theory
Socio Economic Objective 970111
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2002, Arnold
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Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
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