Davies, B. orcid.org/0000-0003-4612-7894 and Parker, J. (2022) Doctors as appointed fiduciaries: a supplemental model for medical decision-making. Cambridge Quarterly of Healthcare Ethics, 31 (1). pp. 23-33. ISSN 0963-1801
Abstract
How should we respond to patients who do not wish to take on the responsibility and burdens of making decisions about their own care? In this paper, we argue that existing models of decision-making in modern healthcare are ill-equipped to cope with such patients and should be supplemented by an “appointed fiduciary” model where decision-making authority is formally transferred to a medical professional. Healthcare decisions are often complex and for patients can come at time of vulnerability. While this does not undermine their capacity, it can be excessively burdensome. Most existing models of decision-making mandate that patients with capacity must retain ultimate responsibility for decisions. An appointed fiduciary model provides a formalized mechanism through which those few patients who wish to defer responsibility can hand over decision-making authority. By providing a formal structure for deferring to an appointed fiduciary, the confusions and risks of the informal transfers that can occur in practice are avoided. Finally, we note how appropriate governance and law can provide safeguards against risks to the welfare of patients and medical professionals.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Author(s). Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | autonomy; doctor–patient relationship; medical decision-making; shared decision-making; Clinical Decision-Making; Decision Making; Humans; Physician-Patient Relations; Physicians |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Arts and Humanities (Sheffield) > Department of Philosophy (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 20 Dec 2023 14:11 |
Last Modified: | 20 Dec 2023 14:11 |
Status: | Published |
Publisher: | Cambridge University Press (CUP) |
Refereed: | Yes |
Identification Number: | 10.1017/s096318012100044x |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:206824 |
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