Brock D W
Brown University, Department of Philosophy, Providence, RI 02912, USA.
Milbank Q. 1996;74(4):599-618.
Policy and practice regarding the proper role of family members in acting as surrogate decision makers for incompetent patients often suffer from an incomplete understanding of the diverse grounds of families' moral authority to act as surrogates. The different, sometimes conflicting, grounds of family surrogacy are explored: (1) its establishment by democratic decision processes; (2) the self-determination of the incompetent patient; (3) the fact that a family member usually acts according to the patient's wishes and interest; (4) the reality that family members are usually most affected by the patient's decisions; (5) consideration of these effects; (6) a recognition that the family is a moral unit, responsible for its members. Each of these grounds must be considered when selecting a surrogate or deciding on the proper scope of the surrogate's decision-making authority.
关于家庭成员作为无行为能力患者的替代决策者的适当角色的政策和实践，往往源于对家庭作为替代者的道德权威的多种依据的不完全理解。本文探讨了家庭代孕的不同依据，有时这些依据相互冲突：（1）通过民主决策过程确立；（2）无行为能力患者的自我决定权；（3）家庭成员通常按照患者的意愿和利益行事这一事实；（4）家庭成员通常受患者决策影响最大这一现实；（5）对这些影响的考量；（6）认识到家庭是一个道德单位，对其成员负责。在选择替代决策者或决定替代者决策权力的适当范围时，必须考虑这些依据中的每一项。
