Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves select and to test the assumption that people want their chosen surrogate to make only a substituted judgement. Methods 30 undergraduate students were recruited. They were presented with a hypothetical scenario about their expected loss of mental capacity in (...) the future and asked to answer some questions about their choice of surrogate. These data were analysed qualitatively using thematic content analysis. Results Most respondents talked about choosing someone who was caring and competent in certain ways, giving interesting evidence for their judgements. Surprisingly few highlighted how well they thought their chosen surrogate knew their preferences and would be able to make a substituted judgement. Moreover, few specified that their chosen surrogate had similar attitudes and values to their own and so would make a similar decision to theirs in the circumstances presented. Some respondents also referred to the social role of their chosen surrogate or the social dynamics of their situation which influenced their choices, as well as to ideas of reciprocity and characteristics of honesty and loyalty. Conclusion In the event that they lose mental capacity, many people will not select a surrogate to decide about medical treatments on their behalf solely on the basis that they expect their surrogate to make a substituted judgement. (shrink)

Self-insight assessment compares outcomes from two model-recovery exercises: a statistical exercise to infer a judge's (implicit) policy and an elicitation exercise whereby the judge describes his or her (explicit) policy. When these policies are mismatched, limited self-insight is not necessarily implied: Shortcomings in either exercise could be implicated, whereby Newell & Shanks' (N&S's)relevanceorsensitivitycriteria for assessing awareness may not be met. Appropriate self-insight assessment requires that both exercises allow the original processes to be captured.

Psychologists' lack of methodological uniformity reflects their greater breadth of enquiry than experimental economists. The need for a theoretical understanding of one-shot decisions validates research undertaken without the repetition of trials. Theories tested only with financial incentives may not reliably predict some classes of decision such as those involving health. Undue emphasis on the importance of replication risks the proliferation of theories with limited generalizability.