Turning failures into successes: a methodological shortcoming in empirical research on surrogate accuracy |
| |
Authors: | Mats Johansson Linus Broström |
| |
Institution: | (1) Department of Philosophy, Lund University, S-222 22 Lund, Sweden;(2) Department of Medical Ethics, Lund University, BMC C13, S-221 84 Lund, Sweden |
| |
Abstract: | Decision making for incompetent patients is a much-discussed topic in bioethics. According to one influential decision making
standard, the substituted judgment standard, a surrogate decision maker ought to make the decision that the incompetent patient
would have made, had he or she been competent. Empirical research has been conducted in order to find out whether surrogate
decision makers are sufficiently good at doing their job, as this is defined by the substituted judgment standard. This research
investigates to what extent surrogates are able to predict what the patient would have preferred in the relevant circumstances.
In this paper we address a methodological shortcoming evident in a significant number of studies. The mistake consists in
categorizing responses that only express uncertainty as predictions that the patient would be positive to treatment, on the
grounds that the clinical default is to provide treatment unless it is refused. We argue that this practice is based on confusion
and that it risks damaging the research on surrogate accuracy.
|
| |
Keywords: | Incompetence Medical decision making Prediction Substituted judgment Surrogate accuracy Uncertainty |
本文献已被 PubMed SpringerLink 等数据库收录! |
|