override refusal, but Boyd argued for a
substituted judgment rule that
(22) However, the court then went on to note that there were four applicable statutes relevant to the decision to terminate a pregnancy (23) and that, therefore, the common law application of
substituted judgment in this instance had been superseded by the statutory standard.
(122) Despite detailed analyses provided in both Roe and Rogers, the Massachusetts Supreme Judicial Court has inconsistently applied the
substituted judgment standard.
Expanded
substituted judgment. Guardians operating under the doctrine of expanded
substituted judgment may base their decisions on the incapacitated person's prior general statements, actions, values, and preferences (Forlik & Whitten, 2012).
Schulze II, decided two years after Schulze I by a different surrogate, and after John J.H., continued the line of thinking expressed in Schulze I, both with respect to the brothers' desire to transfer funds for the purpose of tax planning and maximization of their sister Joyce's assets, as well as the court's reliance on the
substituted judgment standard.
It concluded that reversal of the probate court was required under the doctrine of
substituted judgment regardless of the patient's competency.
While the current law commands that they provide a
substituted judgment, natural law would reject such a one-size-fits-all approach.
First, it examines why one of the standards employed by many courts facing this issue--the
substituted judgment standard--is patently inappropriate for most situations of this nature.
As shown in Bartling the ethicists and courts primarily consider the patient's autonomous choice or, if that's not available, the
substituted judgment of the health care proxy or family.
Substituted judgment. The
substituted judgment criterion requires the surrogate decision-maker to make a decision for another person in the same manner that the other person would if able.
suffering and death."(56) Some versions of
substituted judgment authorize a surrogate decisionmaker to use such data in order to make a best approximation of what the patient would want, if competent.(57)
Little or no research has gone beyond the documentation of physicians' predictive inaccuracies and attempted to identify factors that may improve
substituted judgments. The current study examined the agreement between elderly outpatients' preferences for two types of life-sustaining therapies in two hypothetical medical situations and physicians' predictions of those preferences.