Carter, M. orcid.org/0000-0003-0683-3874 (Cover date: January/February 2022) Advance Directives: The Principle of Determining Authenticity. The Hastings Center Report, 52 (1). pp. 32-41. ISSN: 0093-0334
Abstract
In medical ethics, there is a well-established debate about the authority of advance directives over people living with dementia, a dispute often cast as a clash between two principles: respecting autonomy and beneficence toward patients. In this article, I argue that there need be only one principle in substitute decision-making: determining authenticity. This principle favors a substituted judgment standard in all cases and instructs decision-makers to determine what the patient would authentically prefer to happen—based not merely on the patient’s decisions but also on their present settled dispositions. Adhering to this principle entails that, in a significant range of cases, an advance directive can (and indeed ought to) be overruled.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | This is the peer reviewed version of the following article: Matilda Carter, “Advance Directives: The Principle of Determining Authenticity,” Hastings Center Report 52, no. 1 (2022): 32-41. DOI: 10.1002/hast.1338, which has been published in final form at https://doi.org/10.1002/hast.1338. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. |
Keywords: | dementia, authenticity, advance directives, domination, substitute decision-making, clinical ethics |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Arts, Humanities and Cultures (Leeds) > School of Philosophy, Religion and History of Science (Leeds) |
Date Deposited: | 01 Oct 2025 13:49 |
Last Modified: | 01 Oct 2025 14:15 |
Published Version: | https://onlinelibrary.wiley.com/doi/ftr/10.1002/ha... |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1002/hast.1338 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:230728 |