Hastings Cent Rep. 2019 Mar;49(2):2. doi: 10.1002/hast.984.
The March-April issue of the Hastings Center Report offers another in a series of articles over the last few years on the structure and the ethics of surrogate decision-making. Here, Daniel Brudney addresses how to help the surrogate deal with a treatment decision. A core insight he offers is that the structure of the surrogate's decision has been misunderstood and the misunderstanding makes the task yet harder. As usually understood, the surrogate is supposed to be guided by the question, what would the patient choose, if the patient were making the choice herself? Brudney argues that this conception is impossible, and that the surrogate's task is instead to consider the patient's best interests, as illuminated in part by the patient's expressed values and past choices. This understanding leads, he argues, to a different guiding question: what could the patient choose, given her values?
《 Hastings 中心报告》的 3-4 月刊刊登了过去几年来关于代理决策结构和伦理的一系列文章中的又一篇。在这里，丹尼尔·布鲁德尼探讨了如何帮助代理人做出治疗决策。他提出的一个核心观点是，对代理人决策结构的误解使得这项任务更加困难。按照通常的理解，代理人应该通过这样一个问题来指导自己的决策，即如果患者自己做出选择，她会选择什么？布鲁德尼认为，这种观念是不可能的，相反，代理人的任务是考虑患者的最佳利益，而患者表达的价值观和过去的选择在一定程度上阐明了这一点。他认为，这种理解导致了一个不同的指导问题：考虑到患者的价值观，她可能会做出什么样的选择？
