(15.) It is hardly definitive evidence, but it may be of interest to present the first two hits that came up when I Googled "substituted judgment." Consider a definition of "Substituted Judgement
" (sic) from Ascension Health, found at http://www.ascensionhealth.org/ethics/public/issues/ substituted.asp: "The form of surrogate decision-making regarding end-of-life care in which the surrogate attempts to establish with as much accuracy as possible what decision the patient would have made if that patient were competent to do so.
Robertson, Organ Donations by Incompetents and the Substituted Judgement
Doctrine, 76 COLUM.
Ideally, under the principle of "substituted judgement
" (Casasanto, et al., 1991; Christie, 1984; In re Quinlan, 1976; In re Roe, 1982) the guardian must attempt to reach the decision the incompetent person would make if that person were legally able to choose.
The majority of decisions about the use of life-sustaining medical treatments are made by physicians and family members after patients become incapacited.[1-3] When a patient is no longer able to voice his or her treatment preferences, surrogate decision-makers attempt to make a "substituted judgement
" baed on their knowledge about the patient's values, goals, and prior treatment preferences.
That decision was reached on the basis of his best interests, rather than by a substituted judgement
Even if we agreed with Emanuel that an adult who becomes irreversibly incompetent loses her right to refuse, we might think that the right way to treat her would be in accord with her expressed wishes (advance directives) or with our best judgement about how she would want to be treated ("substituted judgement
To protect the infirm and the disabled, the court rejects as unreliable substituted judgement
or best interests standards for decisionmaking.