The Journal of Clinical Ethics




James Lindemann Nelson, ďFamiliar Interests and Strange Analogies: Baergen and Woodhouse on Extra-Familial Interests,Ē The Journal of Clinical Ethics 24, no. 4 (Winter 2013): 338-42.



      The article by Professor Baergen and Dr. Woodhouse makes a succinct and serious contribution to progress in bioethical understanding of deciding for others. They begin with what is by now a familiar claim: family proxy decision makers may sometimes make decisions on behalf of incapacitated relatives that depart from what might be optimal from the patientís point of view, since the well-being of family members, or of the family as such, may be substantially affected by the direction of a patientís care. They then develop this idea, noting that others apart from family members can also be substantially affected by a patientís treatment, and arguing that the interests of strangers ought also to sometimes have a role in determining the aims and means of a patientís treatment.

       Baergen and Woodhouse also devote attention to how extra-familial interests might be implemented in medical decision making. While I unearth a troubling consequence of the effort to realize their theoretical conclusion practically, my chief task is to point to some disanalogies between families and strangers, and consider the extent to which they call into question the relevance of the interests of strangers to the treatment of patients.



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