Daniel P. Sulmasy, OFM, MD, PhD; Peter B. Terry, MD, MA; Deborah J. Miller, RN, PhD
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Sulmasy D., Terry P., Miller D.; Accuracy of Substituted Judgments in Patients with Terminal Diagnoses. Ann Intern Med. 1998;129:1083. doi: 10.7326/0003-4819-129-12-199812150-00041
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Published: Ann Intern Med. 1998;129(12):1083.
We are in basic agreement with the normative moral points that O'Rourke makes in his letter. However, it is important to keep in mind that our paper is a work of descriptive ethics; it makes no normative moral arguments. Thus, in stating that our “fundamental assumption” is that an “accurate” decision is a “correct” decision, O'Rourke is both right and wrong. He is right in the sense that the paper must assume, for the purposes of describing the ability of a surrogate to represent the wishes of the patient, that an answer that matches what the patient wants is correct. On the other hand, we do not assert that an accurate decision is the morally correct decision. All we can conclude from our study is that to the extent that accurate representation of the patients' wishes by a surrogate decision maker is morally best (and in many cases this is true), accuracy is associated with factors such as a discussion between patient and surrogate, and inaccuracy is associated with factors such as a dying patient's belief that he or she will live another 10 years.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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