Department of Anaesthesia and Intensive Care, Khoo Teck Puat Hospital, Singapore, Singapore.
Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore.
J Med Ethics. 2018 Dec;44(12):851-856. doi: 10.1136/medethics-2016-104084. Epub 2018 Jun 28.
This paper will discuss why and how social network sites ought to be used in surrogate decision making (SDM), with focus on a context like Singapore in which substituted judgment is incorporated as part of best interest assessment for SDM, as guided by the Code of Practice for making decisions for those lacking mental capacity under the Mental Capacity Act (2008). Specifically, the paper will argue that the Code of Practice already supports an ethical obligation, as part of a patient-centred care approach, to look for and appraise social network site (SNS) as a source of information for best interest decision making. As an important preliminary, the paper will draw on Berg's arguments to support the use of SNS information as a resource for SDM. It will also supplement her account for how SNS information ought to be weighed against or considered alongside other evidence of patient preference or wishes, such as advance directives and anecdotal accounts by relatives.
本文将讨论为何以及如何在代理决策制定（SDM）中使用社交网络网站，重点讨论新加坡等情境，在这些情境中，替代性判断被纳入精神能力法（2008 年）下的 SDM 最佳利益评估的一部分。具体来说，本文将认为，行为守则已经支持了一项道德义务，作为以患者为中心的护理方法的一部分，寻找和评估社交网络网站（SNS）作为最佳利益决策制定的信息来源。作为一个重要的前提，本文将借鉴 Berg 的论点，支持将 SNS 信息用作 SDM 的资源。它还将补充她的说法，即如何权衡 SNS 信息或考虑将其与其他患者偏好或意愿的证据（如预先指示和亲属的轶事说明）放在一起。
