Debate has raged over terminating treatment for demented patients, those neither permanently unconscious nor terminally ill. Ronald Dworkin argues that the substituted judgment principle should be adhered to in making treatment decisions for demented patients, honoring the prior preference of even a "pleasantly senile" patient to reject treatment. Rebecca Dresser proposes adherence to a best interests standard focusing only on the current welfare of the patient, even if this would ignore her advance directive. / Few courts have directly faced the issue: When should treatment of demented patients be terminated? No court has justified its decision on the ground that the family of the demented patient should have the preeminent role in decisionmaking for their loved ones. Courts purport to apply the substituted judgment standard, but reach inconsistent results. / I argue that we need not choose between Dworkin's rigid adherence to a substituted judgment principle or Dresser's exclusive focus on the patient's current interests. I propose a new model: When a dilemma is in the moral "gray" zone--with no clearly right answer--the family decision should be granted presumptive validity so long as it is in the range of reasonable options. Reversing the orthodox approach, a family decision could be overridden only by a showing that it is clearly erroneous. This approach recognizes the critical fact that the patient is part of a family; a decision about treatment affects every member.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.27985 |
| Date | January 1997 |
| Creators | Fleischer, Theodore E. |
| Contributors | Elliott, Carl (advisor), Webber, Jeremy (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Laws (Institute of Comparative Law.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001637076, proquestno: MQ37252, Theses scanned by UMI/ProQuest. |
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