Changing the Question

Hastings Center Report 49 (2):9-16 (2019)
  Copy   BIBTEX


Jack, who is seventy‐five years old, is in the hospital with a terminal condition that has undermined his cognitive faculties. He has left no advance directive and has never had a conversation in which he made his treatment wishes remotely clear. Yet now, a treatment decision must be made, and in modern American medicine, the treatment decision for Jack is supposed to be made by a surrogate decision‐maker, who is supposed to use a decision‐making standard known as “substituted judgment.” According to the substituted judgment standard, Jack’s surrogate decision‐maker, his wife, is supposed to decide on his treatment by determining what Jack would do if he did have decisional capacity. That is, she is supposed to answer the question, what would the patient choose? I will argue that this is the wrong question to ask because when the question has a determinate answer, that answer is sometimes not sufficiently connected to the value that is supposed to make the question morally salient, and because sometimes, perhaps often, there is no determinate answer to the question of what the patient would choose. Jointly, these two problems suggest the need for a different question.



    Upload a copy of this work     Papers currently archived: 91,271

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Changing Moods.Hagi Kenaan - 2017 - Philosophia 45 (4):1469-1479.
Changing Universities and the Question of Academic Practice.S. Kitajima - 1999 - Ethics, Policy and Environment 2:254-255.
Public Theology and Changing Social Values.Kenneth Medhurst & James Sweeney - 2004 - Studies in Christian Ethics 17 (2):118-133.
FOCUS: Consistency and Sympathy Changing attitudes through moral theories.Paul Griseri - 1994 - Business Ethics, the Environment and Responsibility 3 (4):201-206.
FOCUS: Consistency and sympathy changing attitudes through moral theories.Paul Griseri - 1994 - Business Ethics, the Environment and Responsibility 3 (4):201–206.


Added to PP

26 (#589,939)

6 months
5 (#632,353)

Historical graph of downloads
How can I increase my downloads?

Author's Profile

Daniel Brudney
University of Chicago

References found in this work

Freedom of the will and the concept of a person.Harry G. Frankfurt - 1971 - Journal of Philosophy 68 (1):5-20.
The Morality of Freedom.Joseph Raz - 1986 - Philosophy 63 (243):119-122.
Moral Luck.Bernard Williams - 1981 - Critica 17 (51):101-105.
The Theory and Practice of Autonomy.Gerald Dworkin - 1988 - Philosophy 64 (250):571-572.

View all 15 references / Add more references