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Related Experiment Videos

The concept of precedent autonomy.

John K Davis1

  • 1The Brody School of Medicine, Department of Medical Humanities, East Carolina University, Brody Medical Sciences Building 2S-17, Greenville, NC 27858-4354, USA. davisjoh@mail.ecu.edu

Bioethics
|June 27, 2002
PubMed
Summary

Respecting patient autonomy means honoring past preferences, even if the patient can no longer understand them. This principle, precedent autonomy, depends on whether the original reasons for the preference still hold true.

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Area of Science:

  • Bioethics
  • Medical Law
  • Philosophy of Medicine

Background:

  • The principle of respect for autonomy mandates honoring a competent patient's treatment preferences.
  • Disagreement exists on whether this includes respecting earlier preferences of incapacitated patients, such as those in advance directives (precedent autonomy).
  • Attributing a disaffirmed preference to an incapacitated patient who can no longer understand it raises ethical concerns.

Purpose of the Study:

  • To analyze the concept of precedent autonomy and its ethical implications in advance medical decision-making.
  • To determine the conditions under which earlier patient preferences can be justifiably respected.
  • To evaluate various approaches to advance medical decision-making in light of precedent autonomy.

Main Methods:

Keywords:
Analytical ApproachProfessional Patient Relationship

Related Experiment Videos

  • Philosophical analysis of the concept of precedent autonomy.
  • Examination of the relationship between preferences and the reasons underlying them.
  • Critique of existing frameworks for advance medical decision-making.

Main Results:

  • Whether an earlier preference is attributable to an incapacitated patient depends on the persistence of the reasons behind it.
  • If the reasons for a preference are contingent on the patient's mental capacity, the preference may cease to exist once capacity is lost.
  • Analysis reveals limitations in approaches based solely on personal identity, soft paternalism, or preference stability.

Conclusions:

  • Respect for precedent autonomy is complex and not always straightforward.
  • The justification for respecting past preferences hinges on the continued relevance of the reasons that formed them.
  • Programmatic recommendations are offered for when and why respecting former preferences remains ethically mandated.