Authenticity and Clinical Decision-Making

Two articles in the January-February 2022 issue of the Hastings Center Report concern authenticity as an aid to clinical decision-making. The lead article, by Matilda Carter, intervenes in a debate concerning decision-making on behalf of people with advance directives instructing that, should they develop dementia, they not be given life-sustaining treatment and who now have the illness and are unable to make informed medical decisions. Carter develops her position on the authority an advance directive should hold in such cases by arguing that the only principle needed for substitute decision-making is that of determining authenticity. In the second article, Ryan Nelson et al. identify pediatric authenticity as an important decision-making standard, especially in caring for children too young to assent to treatment.