On substituted arguments

Clinicians who follow their approach, 'reinterpreting' the substituted judgement standard, could be risking potential legal liability unless the standard is changed. [...]if the intention of Wendler and Phillips is to respect patient autonomy, it is curious that they make no use of data demonstrating that the majority of patients do not want decisions to be guided solely according to their own treatment preferences anyway, but would like to see equal or exclusive weight given to the judgements of their loved ones in making medical decisions for them should they become incapable of deciding for themselves. 5 Thus the question, 'What would your loved one want were she able to speak to us today?' is not the best approximation of the authentic values of most patients and seems disrespectful of their meta-autonomous choices about how they make decisions and how they should be treated. [...]in the example Wendler and Phillips give of a Jehovah's Witness, the Substituted Interests Model would arrive at the same decision as their model: the authentic values and real interests of this patient, as a unique person, would highlight the patient's allegiance to the will of Jehovah and would therefore lead to a decision against transfusion.