Surrogate End-Of-Life Decisions: Projection or Simulation

The principle of respect for patient autonomy and the right of self-determination dominate medical decision-making in developed countries. The concept of prospective autonomy proposes that personal choices ought to inform healthcare decisions for decisionallyincapacitated patients. Such extension of patient’s autonomy is accomplished through advance directive and surrogate decisionmaking; patients are encouraged to document their wishes with respect to life-saving interventions in a living will and their choice of a surrogate decision-maker in a durable power of attorney for healthcare.