Centering Care as Normal and Valuable

This commentary, which responds to the article "Models of Relational Medical Decision-Making: Caregivers and Advanced Life-Sustaining Treatment," by Aaron Wightman and Georgina Campelia, in the same issue of this journal, argues for reorienting medical decision-making around care rather than patient autonomy alone. Drawing on empirical studies and disability bioethics, it asserts that most patients prefer involving physicians and caregivers in decision-making. Empirical studies show that many patients prefer physician-directed or collaborative decisions and commonly weigh the input of caregivers. Additionally, patients frequently factor the potential burden on family into difficult treatment choices, undermining strict substituted decision-making. Normatively, focusing on care acknowledges human dependency and the moral significance of caregiving, which resists ableist tendencies that render carers invisible. The author endorses Wightman and Campelia's care-centered model, showing that it better reflects actual decision-making practices and validates dependence and caregivers' labor.