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Substituted-Judgment Doctrine is a principle that that allows a surrogate decision-maker to attempt to establish, with as much accuracy as possible, what decision an incompetent patient would make if he or she were competent to do so. In theory, the doctrine of substituted judgment looks to the individual to determine what s/he would do in a particular situation if she were competent. This doctrine is applicable to situations where a person, once competent, is rendered incompetent to consent to medical procedures through injury or disease. The once competent person has developed a system of morals and beliefs, and patterns of behavior which the court can examine when evaluating what s/he would do in a particular situation.
The following is a case law discussing Substituted-Judgment :
Courts in substituted judgment cases must probe the patient's value system as an aid in discerning what the patient would choose. Most people do not foresee what calamities may befall them; much less do they consider, or even think about, treatment alternatives in varying situations. The court in a substituted judgment case, therefore, should pay special attention to the known values and goals of the incapacitated patient, and should strive, if possible, to extrapolate from those values and goals what the patient's decision would be. Although treating physicians may be an invaluable source of such information about a patient, the family will often be the best source. Family members or other loved ones will usually be in the best position to say what the patient would do if competent. The court should be mindful, however, that while in the majority of cases family members will have the best interests of the patient in mind, sometimes family members will rely on their own judgments or predilections rather than serving as conduits for expressing the patient's wishes. This is why the court should endeavor, whenever possible, to make an in-person appraisal of the patient's personal desires and ability for rational choice.[In re A.C., 573 A.2d 1235 (D.C. 1990)]