Choosing Now for Later: Precedent Autonomy and Problem of Surrogate Decision-Making After Severe Brain Injury
Patients with disorders of consciousness after severe brain injury need surrogate decision-makers to guide treatment decisions on their behalf. Formal guidelines for surrogate decision-making generally instruct decision-makers to first appeal to a patient’s written advance directive, followed by making a substituted judgement of what the patient would have chosen, and lastly, to make decisions according to what seems to be in the patient’s best medical interests. The basic idea is that past values begin to matter when global incompetence sets in. In this paper, I challenge this rationale, using patients with ‘covert awareness’ as a case study. Patients with ‘covert awareness’ may continue to have values and an authentic sense of self, which may differ from their past values and wishes, despite lacking decision-making capacity in the present. Accordingly, surrogate decision-makers should make decisions based on how the patient is likely to experience their condition in the present, rather than their past wishes and values.
Date:
11 June 2020, 16:00 (Thursday, 7th week, Trinity 2020)
Venue:
Zoom
Speaker:
Dr Mackenzie Graham (University of Oxford)
Organising department:
Oxford Uehiro Centre for Practical Ethics
Organiser:
Dr Doug McConnell (University of Oxford)
Organiser contact email address:
rachel.gaminiratne@philosophy.ox.ac.uk
Host:
Dr Doug McConnell (University of Oxford)
Part of:
New St Cross Special Ethics Seminar Series
Topics:
Booking required?:
Required
Booking url:
https://us02web.zoom.us/webinar/register/WN_zBtjTY4QSaeJoCr7AtBncg
Cost:
free
Audience:
Public
Editor:
Rachel Gaminiratne
