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Licensing Surrogate Decision-Makers.

Publication ,  Journal Article
Rosoff, PM
Published in: HEC Forum
June 2017

As medical technology continues to improve, more people will live longer lives with multiple chronic illnesses with increasing cumulative debilitation, including cognitive dysfunction. Combined with the aging of society in most developed countries, an ever-growing number of patients will require surrogate decision-makers. While advance care planning by patients still capable of expressing their preferences about medical interventions and end-of-life care can improve the quality and accuracy of surrogate decisions, this is often not the case, not infrequently leading to demands for ineffective, inappropriate and prolonged interventions. In 1980 LaFollette called for the licensing of prospective parents, basing his argument on the harm they can do to vulnerable people (children). In this paper, I apply his arguments to surrogate decision-makers for cognitively incapacitated patients, rhetorically suggesting that we require potential surrogates to qualify for this position by demonstrating their ability to make reasonable and rational decisions for others. I employ this theoretical approach to argue that the loose criteria by which we authorize surrogates' generally unchallenged power should be reconsidered.

Duke Scholars

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Published In

HEC Forum

DOI

EISSN

1572-8498

Publication Date

June 2017

Volume

29

Issue

2

Start / End Page

145 / 169

Location

Netherlands

Related Subject Headings

  • Terminal Care
  • Patient Care Planning
  • Mental Competency
  • Life Support Care
  • Humans
  • Family
  • Decision Making
  • Applied Ethics
  • Advance Directives
  • 5001 Applied ethics
 

Citation

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Rosoff, P. M. (2017). Licensing Surrogate Decision-Makers. HEC Forum, 29(2), 145–169. https://doi.org/10.1007/s10730-016-9316-x
Rosoff, Philip M. “Licensing Surrogate Decision-Makers.HEC Forum 29, no. 2 (June 2017): 145–69. https://doi.org/10.1007/s10730-016-9316-x.
Rosoff PM. Licensing Surrogate Decision-Makers. HEC Forum. 2017 Jun;29(2):145–69.
Rosoff, Philip M. “Licensing Surrogate Decision-Makers.HEC Forum, vol. 29, no. 2, June 2017, pp. 145–69. Pubmed, doi:10.1007/s10730-016-9316-x.
Rosoff PM. Licensing Surrogate Decision-Makers. HEC Forum. 2017 Jun;29(2):145–169.
Journal cover image

Published In

HEC Forum

DOI

EISSN

1572-8498

Publication Date

June 2017

Volume

29

Issue

2

Start / End Page

145 / 169

Location

Netherlands

Related Subject Headings

  • Terminal Care
  • Patient Care Planning
  • Mental Competency
  • Life Support Care
  • Humans
  • Family
  • Decision Making
  • Applied Ethics
  • Advance Directives
  • 5001 Applied ethics