Legal Definitions - substituted-judgment doctrine

substituted-judgment doctrine

The substituted-judgment doctrine is a legal principle that applies when an individual is no longer capable of making their own decisions due to incapacitation (e.g., from illness or injury). It directs a designated decision-maker, often called a surrogate or guardian, to determine what the incapacitated person themselves would have chosen if they were still competent to express their wishes. The goal is to honor the individual's known values, beliefs, and past preferences, rather than for the surrogate to make a decision based on what they personally believe is "best." To apply this doctrine, there must be strong evidence—typically "clear and convincing evidence"—to demonstrate what the incapacitated person's choice would have been. This principle is generally used for individuals who once had the capacity to make decisions but have since lost it.

• Example 1: End-of-Life Medical Treatment
  An elderly woman, Ms. Eleanor Vance, developed advanced dementia and is no longer able to communicate her wishes regarding medical care. Before her illness, Ms. Vance had several conversations with her adult children and close friends, explicitly stating that she would never want to be kept alive indefinitely by artificial means if there was no hope of recovery. She never formalized these wishes in a living will. When doctors recommend a feeding tube to prolong her life, her children, acting as her healthcare surrogates, invoke the substituted-judgment doctrine. They present testimony from family and friends about Ms. Vance's consistent past statements and values to argue that she would refuse the feeding tube if she were competent. A court would then assess if this evidence clearly and convincingly demonstrates her prior wishes.

• Example 2: Financial Donation to a Charity
  Mr. David Chen, a successful entrepreneur, suffered a severe stroke that left him unable to manage his finances or express new decisions. Throughout his life, Mr. Chen was a passionate supporter of a local animal shelter, making significant annual donations and volunteering regularly. He had mentioned to his financial advisor and family members that he intended to make a substantial one-time gift to the shelter for a new facility expansion, but he became incapacitated before he could finalize the paperwork. His court-appointed conservator, using the substituted-judgment doctrine, seeks court approval to make the donation. The conservator presents evidence of Mr. Chen's long history of support, his past statements, and his philanthropic patterns to demonstrate that, if competent, he would undoubtedly have made this specific donation.

• Example 3: Relocation Decision for an Incapacitated Adult
  Sarah, a vibrant 30-year-old, was rendered comatose after a car accident. Before the accident, she had always expressed a strong desire to live independently and had recently started planning a move to a new city to pursue a career opportunity, discussing it extensively with her roommate and family. Her parents, who live in a different state, are appointed as her guardians. When doctors determine Sarah will require long-term care, her parents want to move her to a facility near them. However, Sarah's roommate and other friends argue that Sarah would have preferred to stay in her current city, closer to her established social network and the career path she was pursuing. The court would apply the substituted-judgment doctrine, requiring the guardians to present clear and convincing evidence that moving Sarah to their state aligns with what Sarah herself would have chosen if she were able to make that decision, considering her past expressed desires for independence and her future plans.