E-raamat: Making Medical Decisions for the Profoundly Mentally Disabled

A legal and moral analysis of medical decision making on behalf of those with suchsevere cognitive impairments that they cannot exercise self-determination.

In this book, Norman Cantor analyzes the legal and moral status of people withprofound mental disabilities -- those with extreme cognitive impairments that prevent their exerciseof medical self-determination. He proposes a legal and moral framework for surrogate medicaldecision making on their behalf. The issues Cantor explores will be of interest to professionals inlaw, medicine, psychology, philosophy, and ethics, as well as to parents, guardians, and health careproviders who face perplexing issues in the context of surrogate medical decision making.Theprofoundly mentally disabled are thought by some moral philosophers to lack the minimum cognitiveability for personhood. Countering this position, Cantor advances both theoretical and practicalarguments for according them full legal and moral status. He also argues that the concept ofintrinsic human dignity should have an integral role in shaping the bounds of surrogate decisionmaking. Thus, he claims, while profoundly mentally disabled persons are not entitled to make theirown medical decisions, respect for intrinsic human dignity dictates their right to have aconscientious surrogate make medical decisions on their behalf. Cantor discusses the criteria thatbind such surrogates. He asserts, contrary to popular wisdom, that the best interests of thedisabled person are not always the determinative standard: the interests of family or others cansometimes be considered. Surrogates may even, consistent with the intrinsic human dignity standard,sometimes authorize tissue donation or participation in nontherapeutic medical research byprofoundly disabled persons. Intrinsic human dignity limits the occasions for such decisions anddictates close attention to the preferences and feelings of the profoundly disabled personsthemselves. Cantor also analyzes the underlying philosophical rationale that makes thesedecision-making criteria consistent with law and morals.