Decision making for incompetent elderly people is an increasingly serious issue for American society. The decision-making processes we choose will reflect choices among a number of ethical principles--those specifying the purpose of substituted judgment, those guiding the surrogate decision maker, and those used in choosing the surrogate--and depends as well on the way we construe the concept of decision-making competence.
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Buchanan et al. (1986) studied this question.
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