Choosing for Another: Beyond Autonomy and Best Interests
Abstract
According to bioethics orthodoxy, when we ask, "What would the patient choose?" the patient's autonomy is at stake. In fact, what underpins the moral force of that question is a value different from either autonomy or best interests. This is the value of doing things in a way that is authentic to the person.
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The sense of authenticity employed in Dutch concurrent request EAS cases seems to be the sense normally sought in surrogate decision-making after a person has lost decision-making capacity.
“The sense of authenticity employed in Dutch concurrent request EAS cases seems to be in its second sense, namely, authenticity that is normally sought in surrogate decision-making after a person has lost decision-making capacity.(34)”
From Euthanasia and Assisted Suicide of Persons With Dementia in the Netherlands (2020) · cites this paper as [34]
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Who should make the decision on the use of GPS for people with dementia?
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“In a similar way, in an article exploring the moral bases of the different questions a patient’s surrogate decision-maker might have to answer, Brudney (2009) argues that although one’s ‘authenticity’ or will may be important, in some cases other values might override it.”
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Pre-Implantation Genetic Diagnosis and Rational Choice Under Risk and UncertaintyPreprint
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When Does Shared Decision-Making Apply in Adult Critical Care?
Jaffa, M., & Hwang, D. Y. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108633246.002
“Surrogates may also incorporate their own preferences and personal factors in decisionmaking, aside from simply exercising substituted judgment on behalf of the incapacitated patient.(12) The fact that ICU clinicians work with surrogate decision makers on a daily basis does not necessarily mitigate the practical chall…”
BackgroundEthical reflection support for potential organ donors' relatives: A narrative review
Baumann, A., Thilly, N., Joseph, L., & Claudot, F. (2022) · Nursing Ethics · doi:10.1177/09697330211015274
“Three types of narrative approaches – which could be three levels and steps of the relatives’ analysis – were found in the literature: The ‘authentic life’ approach promotes the authenticity of the patient’s life in the sense of continuing the life that the individual lived and maintaining the coherence of the patient…”
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Interpreting ‘What One Would Have Wanted’
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Is Self-Discrimination Disrespectful?
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- Authors
- Brudney, D.
- Corresponding author
- Daniel Brudney
- ORCID
- Daniel Brudney
- Venue
- Hastings Center Report
- Publisher
- Project MUSE
- Published
- 2009
- Volume
- 39
- Issue
- 2
- Pages
- 31-37
- ISSN
- 0093-0334 (ISSN-L)
- 1552-146X
- OpenAlex
- W2004981452
- Cited by
- 101
- References
- 17
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 6 · 2023: 3 · 2022: 8 · 2021: 2 · 2020: 15 · 2019: 10 · 2018: 4 · 2017: 6 · 2016: 5 · 2015: 6 · 2014: 6 · 2013: 5 · 2012: 8
- FWCI
- 6.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Hastings Center Report (publishedVersion)
- PubMed (publishedVersion)
- Project Muse (Johns Hopkins University) (submittedVersion)
- National University of Singapore (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Social Sciences › Arts and Humanities › Philosophy › Philosophical Ethics and Theory
- Keywords
- patient autonomy, best interests, surrogate decision-making, patient choice, authenticity, bioethics, moral values in medicine
- MeSH terms
- Attitude to Death, Decision Making, Ethics, Medical, Humans, Mental Competency, Proxy, Personal Autonomy
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