Legal Definitions - doctrine of substituted judgment

The doctrine of substituted judgment is a legal principle that guides courts or appointed guardians when making decisions for an individual who is no longer capable of making those decisions for themselves due to incapacity (e.g., severe illness, injury, or developmental disability).

Instead of simply deciding what is in the person's "best interest" from an objective standpoint, this doctrine requires the decision-maker to attempt to determine what the incapacitated person would have chosen if they were still competent. This involves considering the individual's known values, beliefs, past preferences, and lifestyle to honor their autonomy as much as possible, even in their incapacitated state.

Here are some examples illustrating the doctrine of substituted judgment:

• Medical Treatment Decisions:

  Imagine Mrs. Chen, an elderly woman, developed advanced dementia. Before her illness, she had repeatedly told her family and documented in a personal letter that she never wanted to be kept alive indefinitely by artificial means if there was no hope of recovery, preferring comfort care. When Mrs. Chen's medical condition deteriorates to a point where life support might be considered, a court applying the doctrine of substituted judgment would not just decide what a "reasonable" person would want. Instead, it would look at Mrs. Chen's previously expressed wishes, her values regarding quality of life versus longevity, and her personal letter. The court would then authorize medical decisions that align with what Mrs. Chen would have chosen for herself, such as withholding aggressive life support and focusing on palliative care.

• Financial Management:

  Consider Mr. Davies, a successful artist, who suffered a severe stroke that left him unable to communicate or manage his affairs. Before his stroke, he had been actively planning to establish a charitable foundation to support emerging artists and had even drafted some initial paperwork. If a guardian is appointed to manage Mr. Davies's substantial estate, the doctrine of substituted judgment would guide their financial decisions. Rather than simply investing his money conservatively or for maximum profit, the guardian would be expected to consider Mr. Davies's known philanthropic intentions. If there's clear evidence of his plan to create an art foundation, the court might authorize the guardian to proceed with establishing it, as this reflects what Mr. Davies would have done if he were still competent.

• Personal Living Arrangements:

  Take the case of Ms. Rodriguez, a fiercely independent woman who always lived alone in her beloved home with a large garden, but then suffered a debilitating accident. She now requires significant assistance but does not need institutional care. Her family, concerned for her safety, believes a nursing home would be the best option. If a court needs to decide on Ms. Rodriguez's living arrangements, the doctrine of substituted judgment would be crucial. Instead of automatically placing her in a nursing home (which might be seen as objectively "safer" by some), the court would consider Ms. Rodriguez's lifelong commitment to independent living, her strong attachment to her home and garden, and any past statements about her desire to remain there. The court would then seek to arrange for in-home care and modifications to her house, if feasible, to allow her to continue living in a manner consistent with what she would have chosen for herself, rather than what others might deem "best."