Synopsis
This book is the most comprehensive treatment available of one of the most urgent--and yet in some respects most neglected--problems in bioethics: decisionmaking for incompetents. Part I develops a general theory for making treatment and care decisions for patients who are not competent to decide for themselves. It provides an in-depth analysis of competence, articulates and defends a coherent set of principles to specify suitable surrogate decisionmakers and to guide their choices, examines the value of advance directives, and investigates the role that considerations of cost ought to play in decisions concerning incompetents. Part II applies this theoretical framework to the distinctive problems of three important classes of individuals, many of whom are incompetent: minors, the elderly, and psychiatric patients. The authors' approach combines a probing analysis of fundamental issues in ethical theory with a sensitive awareness of the concrete realities of health care institutions and the highly personal and individual character of difficult practical problems. Its broad scope will appeal to health professionals, moral philosophers and lawyers alike.
Reviews
In this book, the authors, both professors of philosophy and members of the President's Commission on Medical Ethics, set out a theoretical framework for deciding who is competent to make his own life-or-death decision and who should decide for the incompetent. They advocate "pa tient-centered principles," not paternalism, and would rely on the family, not doctors or courts, for surrogate decisions. The best solution is to have an "advance directive" which specifies the surrogate decision maker and what should not be done to keep one alive. Instead of the "basic interest" found in estate law, the authors substitute "best interest." In the book's second section, they apply the "best interest" principle to cases involving minors, newborns, the elderly, and the mentally ill. For subject collections.
- Janice Dunham, John Jay Coll. Lib., N.Y.
Copyright 1990 Reed Business Information, Inc.
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